Sample records for tardive apres chirurgie

  1. [Tardive dyskinesia--diagnosis and treatment].

    PubMed

    Kazamatsuri, H

    1993-11-01

    Tardive dyskinesia is defined as a syndrome consisting of abnormal, stereotypical involuntary movements usually of choreoathetoid type, principally affected the mouth, face, limbs and trunk, which occurs relatively late in the course of neuroleptic drug treatment and in the etiology of which the drug treatment is a necessary factor. Presently, the prevalence of tardive dyskinesia in the hospitalized patients in psychiatric hospitals in Japan is estimated to be 20-30%. Epidemiology, possible pathophysiology and symptomatology of tardive dyskinesia are briefly described. Differential diagnosis between this syndrome and other involuntary movements such as psychotic mannerism, senile orofacial dyskinesia, rabbit's syndrome, Pisa syndrome or Meige's syndrome is discussed. Several drugs to suppress involuntary movements of tardive dyskinesia are described. However, there appears to be no consistently reliable therapies for patients who develop the tardive dyskinesia. Treatment for this syndrome, other than neuroleptic withdrawal, are still uncertain.

  2. Tardive dyskinesia: Out of the shadows.

    PubMed

    Hauser, Robert A; Truong, Daniel

    2018-06-15

    The approvals of the first two medications, valbenazine and deutetrabenazine, to treat tardive dyskinesia have ushered in a new era in neuropsychiatric care. Tardive syndromes are defined as delayed onset, persistent movement disorders or sensory phenomena that occur in association with exposure to dopamine receptor blocking agents (DRBAs). Their underlying pathophysiology remains to be fully elucidated, but clinicians can conceptualize tardive syndromes as persistent dopamine supersensitivity states. Tardive syndromes can potentially cause distress, disfigurement, embarrassment, and dysfunction, and are often permanent. Therefore, practitioners who prescribe DRBAs should be aware of this potential, carefully assess the risk/benefit ratio when considering the use of these medications, and be sure that patients are appropriately informed. Patients on DRBAs should be monitored for the development of tardive syndromes, including through the use of regularly scheduled Abnormal Involuntary Movement Scale (AIMS) (or similar) examinations. Clinicians prescribing DRBAs should be familiar with the diagnosis and management of tardive syndromes, and be able to institute treatment or refer patients when treatment is appropriate. Future research may focus on the potential benefit of earlier introduction of VMAT2 inhibitors to delay onset or progression of tardive syndromes. More effective treatments are still needed, as are effective, well-tolerated antipsychotics that do not cause tardive syndromes. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Deuterium Tetrabenazine for Tardive Dyskinesia.

    PubMed

    Cummings, Michael A; Proctor, George J; Stahl, Stephen M

    2018-01-01

    Tardive dyskinesia remains a significant, potentially stigmatizing or crippling adverse effect for any patient treated with an antipsychotic medication. While second- and third-generation antipsychotics have exhibited lower annual incidence rates for tardive dyskinesia than classic or first-generation agents, 3.9% versus 5.5%, the estimated incidence rate is only modestly lower. When coupled with the fact that second- and third-generation antipsychotic medications have come to be employed in treating a wider range of disorders (e.g., autism spectrum disorders, mood disorders, personality disorders, etc.), it is clear that the population of patients exposed to the risk of tardive dyskinesia has expanded. On April 3, 2017, the U.S. Food and Drug Administration (FDA) approved a deuterated version of tetrabenazine (Xenozine®) for the treatment of the involuntary choreic movements associated with Huntington's disease. More recent data, however, have indicated that deuterium tetrabenazine or deutetrabenazine (Austedo®) is effective in treating tardive dyskinesia. Moreover, like the other derivative of tetrabenazine, valbenazine (Ingrezza®), deutetrabenazine offers less frequent dosing and a better short-term adverse effect profile than that of tetrabenazine. Longer use in a broader range of patients, however, will be required to identify risks and benefits not found in short-term trials, as well as optimal use parameters for treatment of tardive dyskinesia.

  4. [Bilateral Pallidotomy for Tardive Dystonia:A Case Report].

    PubMed

    Kohara, Kotaro; Taira, Takaomi; Horisawa, Shiro; Hanada, Tomoko; Kawamata, Takakazu

    2017-11-01

    Tardive dystonia is a movement disorder related to the use of dopamine-receptor-blocking drugs. Several reports have shown that deep brain stimulation of the globus pallidus internus(GPi-DBS)is effective in treating tardive dystonia. However, a few reports demonstrated the efficacy of ablation of the GPi(pallidotomy). We herein report a case of tardive dystonia successfully treated with bilateral pallidotomy. A 32-year-old man developed severe tardive dystonia 10 years after the chronic use of antipsychotic drugs. Withdrawal of the drugs and botulinum toxin injections were ineffective. The patient underwent bilateral pallidotomy for tardive dystonia because of rejection of the implanted DBS devices. Significant improvement was observed, with a 95% decrease in the Burke-Fahn-Marsden Dystonia Rating Scale(BFMDRS)movement score, and no severe adverse events occurred. Symptomatic relief persisted for nine months. Pallidotomy is a feasible and efficacious procedure for tardive dystonia treatment without the use of hardware implantations.

  5. Les complications tardives de prothèse totale de la hanche: à propos de 42 cas

    PubMed Central

    Azarkane, Mohamed; Boussakri, Hassan; Shimi, Mohamed; Elibrahimi, Abdlehalim; Elmrini, Abdlemeji

    2013-01-01

    L'arthroplastie de la hanche est un moyen fiable dans le traitement des affections de la hanche. En lui rendant sa mobilité sa stabilité et son indolence. Cependant cette chirurgie prothétique expose au risque de la survenue des complications qui peuvent engager le pronostic fonctionnel. Nous avons réalisé une étude rétrospective sur une durée de 8 ans de janvier 2004 au janvier 2012 au service de traumatologie-orthopédie de CHU HASSAN II FEZ. Pendant cette période nous avons opéré 240 patients pour PTH. Après un recul moyen de 5 ans nous avons noté chez 42 (17,4%) patients une complication tardive. Nous noté 13 cas de descellement aseptique soit 5,4%. Cette complication a été survenue dans notre série sur une prothèse cimentée dans 8 cas et non cimentée dans 5 cas. Le traitement que nous avons adopté dans notre série a été une reprise de PTH sans greffe osseuse ni anneau de reconstruction dans 4 cas, reprise avec mise en place d'anneau de Kerboull dans 7 cas et reprise avec greffe osseuse et anneau de kerboull dans 2 cas. Nous avons trouvé 11 cas de sepsis tardive soit 4,6% des cas. Nous avons le diabète comme facteur de risque chez 3 malades. L'agent causal a été staphylococcus épdermidis dans 5 cas, colibacille dans 2 cas et association staphylococcus-BGN dans 1 cas. Les différentes modalités que nous avons utilisé pour traiter l'infection dans notre ont été un lavage simple, système d'irrigation-drainage et réimplantation simple en un seul temps ou en 2 temps avec couverture systématique par une antibiothérapie adaptée selon l'antibiogramme. Nous avons noté également 11 cas de fracture sur PTH intéressant dans tous les cas le fémur, nous avons traité ce type de fracture dans notre série par une tige fémorale prothétique longue dans 4 cas, une plaque vissée cerclée dans 3 cas et cerclage simple dans 4 cas. La consolidation a été obtenue chez 9 patients avec 2 cas de pseudarthrose. Nous avons noté 7 cas de

  6. Récidive après dix ans de tumeur de granulosa de l’ovaire: à propos de deux cas et revue de la littérature

    PubMed Central

    Majdoul, Soufya; Tawfiq, Nezha; Bourhaleb, Zouhour; Naqos, Nora; Taleb, Amina; Bouchbika, Zineb; Benchakroun, Nadia; Jouhadi, Hassan; Sahraoui, Souha; Benider, Abdelatif

    2016-01-01

    Les tumeurs à cellules de la granulosa (TG) de l’ovaire sont des tumeurs rares appartenant au groupe des tumeurs des cordons sexuels et du stroma. Elles représentent 0,6 à 3 % de l’ensemble des tumeurs de l’ovaire et 5 % des tumeurs malignes On distingue deux types: le type juvénile (TGJ) qui se caractérise par son agressivité et le type adulte (TGA) qui est le type le moins agressif et le plus fréquent. Les rechutes de TG de l'ovaire surviennent généralement dans les cinq ans, elles sont rarement sous forme de métastases péritonéales ou locales. Bien que, des options de traitement y compris la chirurgie avec ou sans chimiothérapie et ou radiothérapie ont été rapportés pour le traitement des récidives des TG, il n'y a aucune prise en charge standardisée de récidive de cette maladie. Ici, nous rapportons notre stratégie thérapeutique dans la prise en charge des récidives tardives, après dix ans, de la TG sous forme de carcinose péritonéale pour deux patientes avec une revue de la littérature. PMID:28154722

  7. Expected incidence of tardive dyskinesia associated with atypical antipsychotics.

    PubMed

    Glazer, W M

    2000-01-01

    Given the problematic nature of tardive dyskinesia in persons taking conventional antipsychotics, evaluation of newer atypical antipsychotic agents should include a systematic assessment of tardive dyskinesia liability. Results of a prospective double-blind, randomized study of schizophrenic patients who participated in 3 preclinical olanzapine studies and were treated with 5 to 20 mg/day of olanzapine (N = 1192) or haloperidol (N = 522) recently indicated a significantly lower risk of development of tardive dyskinesia with olanzapine treatment than haloperidol treatment. This article discusses the known effects of atypical antipsychotic medications on tardive dyskinesia movements (both withdrawal and persistent) and the incidence rate of tardive dyskinesia among schizophrenic patients undergoing long-term treatment with olanzapine or haloperidol.

  8. VMAT2 Inhibitors for Tardive Dyskinesia-Practice Implications.

    PubMed

    Peckham, Alyssa M; Nicewonder, Jessica A

    2018-01-01

    Tardive dyskinesia is a potentially irreversible, debilitating, hyperkinetic movement disorder that can result from dopamine receptor antagonists. Prompt recognition and resolution of symptoms are instrumental in preventing disease irreversibility, though current treatment options have fallen short of robust, effective, and long-term symptom control. In April 2017, the Food and Drug Administration (FDA) approved 2 new vesicular monoamine transporter 2 (VMAT2) inhibitors, deutetrabenazine and valbenazine, for chorea related to Huntington's disease and tardive dyskinesia, respectively. These agents were pharmacologically modified from tetrabenazine, a VMAT2 inhibitor used off-label in the treatment of tardive dyskinesia. Despite FDA-labeled indications of deutetrabenazine and valbenazine, each agent was explored as a treatment option for those with tardive dyskinesia. In this study, the pharmacologic modifications of the 2 new VMAT2 inhibitors are described, with detailed explanation as to how these may impact clinical practice. The associated case series, observational studies, and clinical trials exploring their use in the treatment of tardive dyskinesia are reported with expert opinion on practice implication.

  9. Tardive Dyskinesia and Covert Dyskinesia with Aripiprazole: A Case Series.

    PubMed

    Patra, Suravi

    2016-01-01

    Aripiprazole, a dopamine stabilizing atypical antipsychotic is used in treatment of tardive dyskinesia caused by other neuroleptics. Tardive dyskinesia is rarely caused by Aripiprazole and has only been documented in high risk patients i.e., female gender, advanced age, affective illness, coexisting neurological disorders. Here the author describes two atypical cases of tardive dyskinesia associated with Aripiprazole. First case of tardive dyskinesia was observed in a neuroleptic naïve young adult male with paranoid illness after six months of treatment with Aripiprazole upon addition of Fluoxetine and the second case was a middle aged female with affective illness where dyskinetic movements appeared after stopping Aripiprazole. The role of Fluoxetine in causing tardive dyskinesia with Aripiprazole and covert dyskinesia due to Aripiprazole with appropriate management is discussed.

  10. Tardive dyskinesia successfully treated with alprazolam.

    PubMed Central

    Jordan, H. W.; Williams, B. C.

    1990-01-01

    Tardive dyskinesia is a disorder secondary to prolonged treatment (from 18 months to 3 years) with antipsychotic agents, affecting approximately 15% to 20% of patients. Tardive dyskinesia is characterized by difficulty controlling involuntary movements of the small muscle groups, producing tic-like reactions, muscle rigidity, and difficulty maintaining muscle tone. It is a chronic and unrelenting disorder which may be permanent if not successfully treated. The mechanism of action is thought to be secondary to dopamine hypersensitivity resulting from prolonged deprivation of dopamine on the part of dopamine-sensitive receptors. Theoretically, these receptors have been deprived of the neurotransmitter by chronic treatment with antipsychotic drugs, which are recognized as dopamine-blocking agents. We present a case in which alprazolam was successfully used in treating tardive dyskinesia. PMID:2213917

  11. U.S. plastic surgeons who contributed to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive (1931-1938): "Giants" in our specialty.

    PubMed

    Rogers, B O

    1999-01-01

    The Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938), edited by Maurice Coelst, M.D. from Brussels, were the first, full-fledged medical publications specifically devoted to plastic, reconstructive, and aesthetic surgery. Publishing original articles by J.W. Maliniac, J. Eastman Sheehan, and brief summaries of papers read at plastic surgery societies by C.R. Straatsma, L.A. Peer, G. Aufricht, and other well-known American plastic surgeons, these Revues drew attention to surgeons, most of whom were responsible for organizing the American Society of Plastic and Reconstructive Surgeons in 1931, the same year in which the Revue de Chirurgie Plastique first appeared.

  12. State-dependent tardive dyskinesia in manic-depressive illness.

    PubMed Central

    de Potter, R W; Linkowski, P; Mendlewicz, J

    1983-01-01

    We report the occurrence of a drug-resistant tardive dyskinesia coexistent with Parkinsonism-like symptoms in a manic-depressive patient. The tardive dyskinesia completely disappeared during the manic phases and recurred after remission over the course of different mood-cycles. PMID:6136551

  13. Valbenazine for the treatment of tardive dyskinesia.

    PubMed

    Müller, Thomas

    2017-12-01

    Chronic intake of typical neuroleptics or centrally acting dopamine receptor blocking antiemetics may cause onset of tardive syndromes. Various types exist. One of them is tardive dyskinesia, characterised by often stigmatising, purposeless, rapid, repetitive, stereotypic, involuntary movements of face, limbs or trunk. Effective symptomatic drug treatment options beyond application of tetrabenazine are rare. Tetrabenazine is usually administered three times daily due to the short half life of this agent. Areas covered: This narrative review discusses the value of valbenazine for the treatment of tardive dyskinesia as a therapeutic alternative to tetrabenazine. Expert commentary: Valbenazine is a selective inhibitor of vesicular monoamine transporter 2, which is metabolized to (+)-alpha-dihydrotetrabenazine. Valbenazine and particularly its metabolite inhibit vesicular monoamine transporter 2 function. Once daily intake of valbenazine ameliorated the severity of tardive dyskinesia. The chiral purity of valbenazine circumvents generation of the (-)alpha and (+) and (-)beta dihydrotetrabenazine metabolites of tetrabenazine or deutetrabenazine. Valbenazine and its metabolite do not antagonize postsynaptic monoamine receptors in contrast to the tetrabenazine formulations. Therefore one may hypothesize that fewer and less severe motor and psychopathological side effects will occur during valbenazine long term application compared with tetrabenazine or deutretrabenazine.

  14. [Risk factors for tardive movement disorders in schizophrenia].

    PubMed

    Tenback, D E; Bakker, P R; van Harten, P N

    2015-01-01

    Tardive movement disorders are common among patients with schizophrenia. Risk factors for movement disorders are of the utmost importance in the context of preventive strategies. To achieve clearer classification of movement disorders in schizophrenia, to identify the risk factors involved and thereby develop strategies to prevent movement disorders. We searched PubMed for prospective studies which had been performed in homogeneous target populations with schizophrenia and which contained well-defined definitions of the movement disorders. From these we selected studies in which risk factors were repeatedly identified. Tardive dyskinesia is well documented. Risk factors for developing tardive dyskinesia are use of antipsychotics, particularly those belonging to the first generation, 'not belonging to the Caucasian race', early extrapyramidal symptoms and older age. So far, there is very little conclusive evidence regarding the genetics of tardive movement disorders. With regard to tardive dyskinesia, not belonging to the Caucasian race and old age are two risk factors that can be quickly determined for the purpose of prevention. In this case it leads to the choice of medication with a low D2 affinity. Furthermore, it is advisable, after commencing treatment with an antipsychotic drug, to evaluate on a regular basis if the patient is showing (early) signs of TD. If TD does occur, there is a choice between medication with a low D-2 affinity or clozapine.

  15. Incidence of Tardive Dyskinesia with Atypical and Conventional Antipsychotic Medications: Prospective Cohort Study

    PubMed Central

    Woods, Scott W.; Morgenstern, Hal; Saksa, John R.; Walsh, Barbara C.; Sullivan, Michelle C.; Money, Roy; Hawkins, Keith A.; Gueorguieva, Ralitza V.; Glazer, William M.

    2011-01-01

    Objective Most previous studies of the incidence of tardive dyskinesia with atypical compared to conventional antipsychotics have not had tardive dyskinesia as their primary focus. The current study aimed to compare the incidence of tardive dyskinesia with atypical vs. conventional antipsychotics using methods similar to those from a previous prospective cohort study at our site in the 1980s. Method 352 initially tardive dyskinesia-free psychiatric outpatients were examined for a new diagnosis of tardive dyskinesia every 6 months for up to 4 years at a community mental health center. At baseline, subjects were receiving conventional antipsychotics only (23%), atypicals only (64%), or both (14%). Only 26 subjects had never received conventional antipsychotics. Results Compared with subjects treated with conventional antipsychotics alone since the previous visit, the adjusted tardive dyskinesia incidence rate-ratio for subjects treated with atypical antipsychotics alone was 0.68 (95% confidence interval 0.29 to 1.64). The incidence and prevalence of tardive dyskinesia was similar to previous findings at this site in the 1980s. Conclusion The incidence of tardive dyskinesia with recent exposure to atypical antipsychotics alone was more similar to that for conventional antipsychotics than in most previous studies. Despite high penetration of atypical antipsychotics into clinical practice, the incidence and prevalence of tardive dyskinesia appeared relatively unchanged since the 1980s. Clinicians should continue to monitor for tardive dyskinesia, and researchers should continue to pursue efforts to treat or prevent it. PMID:20156410

  16. Valbenazine granted breakthrough drug status for treating tardive dyskinesia.

    PubMed

    Müller, Thomas

    2015-06-01

    The chronic use and high dosing of typical neuroleptics or centrally acting dopamine receptor blocking antiemetics predispose patients to the onset of tardive syndromes. One particular subtype, tardive dyskinesia, is characterized by rapid, repetitive, stereotypic, involuntary movements of the face, limbs or trunk. The inhibition of the vesicular monoamine transporter system, using tetrabenazine therapy, improves the severity of tardive dyskinesia. But there are also drawbacks to tetrabenazine treatment, such as a fluctuating response and the need for frequent intake due to its rapid metabolism. Clinical research on the potentially more efficacious and easier to use tetrabenazine analogs is already under way. One of them is valbenazine, the purified parent drug of the (+)-α-isomer of tetrabenazine. The FDA lowered approval hurdles for valbenazine due to a successful Phase II trial, which showed a distinctive improvement in tardive dyskinesia symptoms during valbenazine administration. This resurgence in the clinical research of tardive syndrome therapy is most welcome. This author notes that the putative long-term side effects of valbenazine should carefully be investigated in the future via naturalistic observational trials. Furthermore, valbenazine may also support the onset of symptoms, such as Parkinsonism and depression, with chronic administration, as it, to a certain extent, shares the mode of action of tetrabenazine.

  17. Treatment of tardive dyskinesia with choline and tetrabenazine.

    PubMed Central

    Snell, A. P.; Cleary, M.; Sambrook, M.

    1980-01-01

    A patient with severe tardive dyskinesia due to long-term neuroleptic medication is described. The 2 factors immediately precipitating the onset of the disorder appeared to be the administration of benzhexol hydrochloride and the sudden termination of neuroleptic therapy. the disorder was satisfactorily controlled with choline chloride and a small dose of tetrabenazine. The suggested mechanism of tardive dyskinesia is discussed. PMID:7465478

  18. Conservative approach to tardive dyskinesia-induced neck and upper back pain.

    PubMed

    Reifsnyder, Jeremy W; Tettambel, Melicien A

    2013-08-01

    The management of schizophrenia typically involves the use of antipsychotics (neuroleptics). Use of such medications, however, can result in tardive dyskinesia, or the involuntary contracture of muscles, and associated symptomatic somatic dysfunction. The authors present a case of a 29-year-old woman who presented to a family medicine clinic for ongoing management of schizophrenia with noticeable tardive dyskinesia and complaints of neck and upper back pain. Conventional management of tardive dyskinesia involves either a change in or reduction of the offending antipsychotic. In the present case, the patient received osteopathic manipulative treatment in addition to conventional care for the management of her neck and upper back pain. Although not curative, osteopathic manipulative treatment can provide palliative relief for patients with tardive dyskinesia.

  19. Scientific contributions of U.S. plastic surgeons to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938).

    PubMed

    Vrebos, J

    1999-01-01

    The author emphasizes the close cooperation between U.S. plastic surgeons and the first international journal entirely devoted to plastic surgery, the Revue de Chirurgie Plastique (1931-1934) later to become the Revue de Chirurgie Structive (1935-1938) published under the editorship of Maurice Coelst, M.D. from Brussels. By the accurate recording of original articles, book reviews, proceedings of their annual meetings and summaries in three different languages (English, French, German), the author stresses the intense scientific dynamism and the achievements made by the U.S. pioneers of this new speciality, which really started during World War I.

  20. Molindone and haloperidol in tardive dyskinesia.

    PubMed

    Glazer, W M; Hafez, H M; Benarroche, C L

    1985-08-01

    Preliminary results are described from a study of 11 outpatients manifesting exacerbated tardive dyskinesia after tapering and withdrawal of neuroleptic medications. Patients were randomly assigned to molindone or haloperidol under double-blind placebo-controlled conditions to compare the masking effects of the two drugs. Haloperidol treatment masked withdrawal-exacerbated tardive dyskinesia more than molindone did; this difference (measured by percent change in AIMS scores) was significant (p = .04) when the dose was 200% but not 100% of the prestudy neuroleptic dose. Despite several limitations to the study, the results suggest that molindone may have less dyskinetogenic potential than haloperidol. Further research in the area of site-specificity of molindone is indicated.

  1. Incidence of tardive dyskinesia with atypical versus conventional antipsychotic medications: a prospective cohort study.

    PubMed

    Woods, Scott W; Morgenstern, Hal; Saksa, John R; Walsh, Barbara C; Sullivan, Michelle C; Money, Roy; Hawkins, Keith A; Gueorguieva, Ralitza V; Glazer, William M

    2010-04-01

    Most previous studies of the incidence of tardive dyskinesia with atypical antipsychotics compared with conventional antipsychotics have not had tardive dyskinesia as their primary focus. The current study aimed to compare the incidence of tardive dyskinesia with atypical vs conventional antipsychotics using methods similar to those from a previous prospective cohort study at our site in the 1980s. Three hundred fifty-two initially tardive dyskinesia-free psychiatric outpatients (diagnosed at baseline using the Structured Clinical Interview for DSM-IV) were examined for a new diagnosis of tardive dyskinesia (using the Abnormal Involuntary Movement Scale and Glazer-Morgenstern criteria) every 6 months for up to 4 years at a community mental health center. At baseline, subjects were receiving conventional antipsychotics only (23%), atypicals only (64%), or both (14%). Only 26 subjects had never received conventional antipsychotics. Baseline evaluations were conducted from November 2000 through May 2003. Follow-ups were conducted through February 2005. Compared with subjects treated with conventional antipsychotics alone since the previous visit, the adjusted tardive dyskinesia incidence rate-ratio for subjects treated with atypical antipsychotics alone was 0.68 (95% CI, 0.29-1.64). The incidence and prevalence of tardive dyskinesia was similar to previous findings at this site in the 1980s. The incidence of tardive dyskinesia with recent exposure to atypical antipsychotics alone was more similar to that for conventional antipsychotics than in most previous studies. Despite high penetration of atypical antipsychotics into clinical practice, the incidence and prevalence of tardive dyskinesia appeared relatively unchanged since the 1980s. Clinicians should continue to monitor for tardive dyskinesia, and researchers should continue to pursue efforts to treat or prevent it. Copyright 2010 Physicians Postgraduate Press, Inc.

  2. [Thoughts on the Revue de Chirurgie Plastique (1931-34) and the Revue de Chirurgie Structive (1935-38)].

    PubMed

    Vrebos, J

    2007-08-01

    The history of modern plastic surgery starts when a young, restless ENT man, Dr M. Coelst, started a training in Plastic Surgery with Sebileau in Paris and Joseph in Berlin. This man of vision and far-sighted imagination realized that the separated efforts and publications of so many pioneers, scaterred all over the world, would be lost if not gathered in a scientific journal only devoted to plastic surgery for the benefit of all. This brought him to the idea of establishing, in 1931, at his own initiative, the first international Journal of Plastic Surgery ever published, the Revue de Chirurgie Plastique, fifteen years before the USA Journal Plastic and Reconstructive Surgery and sixteen years before the British Journal of Plastic Surgery. The name of the journal was changed in 1935 to the Revue de Chirurgie Structive. Coelst' Revue was promptly accepted as the leading Journal of Plastic Surgery and all the internationally known plastic Surgeons contributed to it by scientific papers of great value, even today.

  3. British plastic surgeons who contributed to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive (1931-1938): "the Big Four" in their Speciality.

    PubMed

    Rogers, B O

    2001-01-01

    The Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938), edited by Maurice Coelst, M.D. from Brussels, were the first, full-fledged medical publications devoted specifically to plastic, reconstructive, and aesthetic surgery. Publishing original articles by H.D. Gillies, P.T. Kilner, A.H. McIndoe, and R. Mowlem--the "Big Four" as they were known to both English and American plastic surgeons--the Revues drew attention to these four surgeons who were mainly responsible for developing the prestige of English plastic surgery in the early 1930s.

  4. Plasma HVA, tardive dyskinesia and psychotic symptoms in long-term drug-free inpatients with schizophrenia.

    PubMed

    Muscettola, G; Barbato, G; de Bartolomeis, A; Monteleone, P; Pickar, D

    1990-09-01

    Plasma homovanillic acid (pHVA) levels were measured in 16 chronically ill patients with schizophrenia who also suffered from tardive dyskinesia, and in a group of 14 chronically ill patients with schizophrenia who did not have tardive dyskinesia. All patients were studied following an extensive drug-free period (mean = 32.9 months). Patients with orofacial dyskinesia had significantly lower levels of pHVA than did controls. In patients without tardive dyskinesia, pHVA levels were significantly correlated with both positive and negative symptomatology. In contrast, pHVA levels from patients with tardive dyskinesia bore neither a significant nor a nearly significant relationship to symptomatology. The implications of these findings for dopaminergic models of tardive dyskinesia are discussed.

  5. A Review of Differences in Clinical Characteristics between Tardive Syndrome Induced or Improved by Aripiprazole Treatment.

    PubMed

    Chen, Yen-Wen; Tseng, Ping-Tao

    2016-09-15

    Tardive syndrome is a troublesome complication secondary to the long-term usage of antipsychotic medication. At present, there is a lack of effective treatment for tardive syndrome. Aripiprazole has been used in the treatment of tardive syndrome, with some reports of a good response. However, other reports have suggested that tardive syndrome can actually be induced by aripiprazole. The aim of current study was to investigate whether aripiprazole is beneficial or harmful for the treatment of tardive syndrome in specific patients. We performed a thorough literature search via PubMed. We included all of the studies discussing the relationship between tardive syndrome and aripiprazole, either with regards to "inducing" or "improving" the disease. None of the included studies were well-designed clinical trials, and all were case reports or case series. A total of 26 articles were included in which aripiprazole induced tardive syndrome, and another 24 in which tardive syndrome was improved by aripiprazole treatment. In the "improved" group, there were significantly more cases of schizophrenia than in the "induced" group (p=0.002). However, there were significantly more cases with other miscellaneous diagnoses in the "induced" group than in the "improved" group (p=0.003). In addition, the cases in the "induced" group had a significantly longer duration of aripiprazole usage than those in the "improved" group (p=0.001). Current study is important for clinicians to pay attention to the risk of tardive syndrome when prescribing aripiprazole in patients with a diagnosis other than a psychiatric illness or in the long-term administration of aripiprazole.

  6. The scientific contributions of British Plastic Surgeons to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938).

    PubMed

    Vrebos, J

    2001-01-01

    In 1931, Maurice Coelst, M.D. from Brussels started the publication of the first international journal of plastic surgery ever published: the Revue de Chirurgie Plastique (1931-1934), which eventually became the Revue de Chirurgie Structive (1935-1938). In 1936, he established the first European Society of Structive Surgery, which held its first congress in Brussels. Further congresses were held in London in 1937 and in Milan in 1938. It is the collaboration and the participation of British plastic surgeons in this Society, this journal, and these meetings that I want to stress, because I am firmly convinced that these documents fill a gap in the history of Plastic Surgery in Great Britain, since--as far as I know--no detailed information concerning this period was ever published in Plastic Surgery literature.

  7. Epidémiologie et facteurs de risque des complications respiratoires majeures après chirurgie de l'aorte abdominale au CHU Ibn Sina, Maroc

    PubMed Central

    Awab, Almahdi; Elahmadi, Brahim; Lamkinsi, Tarik; El Moussaoui, Rachid; El Hijri, Ahmed; Azzouzi, Abderrahim; Alilou, Mustapha

    2013-01-01

    Introduction L'incidence des complications respiratoires postopératoires (CRPO) reste très diversement appréciées selon les critères diagnostiques retenues dans les différentes études, ce qui la fait varier de 5 à plus de 50%. Les CRPO majeurs après chirurgie de l'aorte abdominale sont responsables d'une grande morbi-mortalité pouvant aller jusqu’à 36%, d'une durée d'hospitalisation et d'un coût plus importants. Ainsi dans l'optique d'améliorer notre prise en charge périopératoire de la chirurgie de l'aorte, nous avons décidé de mener une étude pour dresser le profil épidémiologique et déterminer les facteurs de risque des complications respiratoires dans notre contexte Méthodes Il s'agit d'une étude de cohorte rétrospective du mois de Janvier 2007 au mois de décembre 2011 portant sur l'ensemble des patients opérés pour pathologie aortique au bloc opératoire central de l'hôpital Ibn Sina de Rabat, Maroc. Résultats Cent vingt cinq patients ont été inclus dans notre étude, 24 patients ont été opérés pour anévrysme de l'aorte abdominale et 101 patients pour lésion occlusive aortoiliaque. Dans notre série 22 malades soit 17,6% ont présenté une complication respiratoire majeure avec, une reventilation dans 4,8% des cas, une difficulté de sevrage de la ventilation artificielle dans 3,2% des cas, une pneumopathie dans 4% des cas, un syndrome de détresse respiratoire aigue (SDRA) dans 4% des cas et une nécessité de fibroaspiration bronchique dans 1,6% des cas. En analyse univariée: l’âge, la présence d'une BPCO avec dyspnée stade 3 ou 4, la présence d'une anomalie à l'EFR préopératoire, la présence d'un stade avancé (III ou IV) de LOAI et la reprise chirurgicale étaient statistiquement associés à la survenue d'une complication respiratoire postopératoire. En analyse multivariée, seule une anomalie à l'EFR en préopératoire constituait un facteur de risque indépendant de survenue d'une complication

  8. CMHC practices related to tardive dyskinesia screening and informed consent for neuroleptic drugs.

    PubMed

    Benjamin, S; Munetz, M R

    1994-04-01

    The authors conducted a national survey of community mental health centers to determine their policies and practices about screening patients for tardive dyskinesia and obtaining informed consent for use of neuroleptic drugs. Clinical directors of 235 centers in the United States, selected by geographic region and population, were surveyed through a nine-item questionnaire. Although nearly all the 160 respondents reported that they screened patients for tardive dyskinesia, only about two-fifths had formal screening policies, and about two-fifths had screening programs. The Abnormal Involuntary Movement Scale examination was used by almost two-thirds of respondents who screened patients, and about one-fifth relied on unstructured observation. Slightly more than half of respondents specified a frequency for screening examinations, at a modal interval of six months. Seventy percent used nonpsychiatric clinicians for screening. Almost three-quarters of the respondents had informed consent policies for use of neuroleptics. Urban centers tended to be more aware than rural centers of the American Psychiatric Association's tardive dyskinesia screening guidelines. They also used fewer nonmedical practitioners for screening and were more likely to obtain informed consent for neuroleptics. Despite the existence of APA guidelines and state policies and regulations about tardive dyskinesia screening, a national effort to educate clinicians about prevention of tardive dyskinesia is still needed.

  9. Ineffectiveness of deanol in tardive dyskinesia: a placebo controlled study.

    PubMed

    de Montigny, C; Chouinard, G; Annable, L

    1979-11-01

    In a double-blind placebo-controlled study, deanol acetamidobenzoate, administered in doses up to 1.5 g q.d. for three weeks to chronic schizophrenic patients presenting moderate to severe tardive dyskinesia, failed to alleviate the dyskinetic movements. However, there was a tendency for a significant increase in the schizophrenic symptoms of the deanol-treated group relative to the control group. The ineffectiveness of deanol in alleviating tardive dyskinesia is consistent with its inability to enhance brain acetylcholine synthesis. The worsening of the schizophrenic symptoms may possibly result from an interference by deanol with central cholinergic function.

  10. An Update on Tardive Dyskinesia: From Phenomenology to Treatment

    PubMed Central

    Waln, Olga; Jankovic, Joseph

    2013-01-01

    Tardive dyskinesia (TD), characterized by oro-buccal-lingual stereotypy, can manifest in the form of akathisia, dystonia, tics, tremor, chorea, or as a combination of different types of abnormal movements. In addition to movement disorders (including involuntary vocalizations), patients with TD may have a variety of sensory symptoms, such as urge to move (as in akathisia), paresthesias, and pain. TD is a form of tardive syndrome—a group of iatrogenic hyperkinetic and hypokinetic movement disorders caused by dopamine receptor-blocking agents. The pathophysiology of TD remains poorly understood, and treatment of this condition is often challenging. In this update, we provide the most current information on the history, nomenclature, etiology, pathophysiology, epidemiology, phenomenology, differential diagnosis, and treatment of TD. PMID:23858394

  11. Deanol, lithium and placebo in the treatment of tardive dyskinesia. A double-blind crossover study.

    PubMed

    Jus, A; Villeneuve, A; Gautier, J; Jus, K; Villeneuve, C; Pires, P; Villeneuve, R

    1978-01-01

    A double-blind crossover study on the effects of deanol and lithium carbonate was conducted on a sample of 29 chronic schizophrenic patients with tardive dyskinesia. In addition to his usual treatment with different neuroleptics, each patient received during an 8-week period either deanol, lithium carbonate or placebo. A 4-week wash-out period was inserted between each of the 8-week periods of experimental treatment of the tardive dyskinesia. The administration of either deanol, lithium carbonate or placebo added to the neuroleptic treatment did not produce a statistically significant improvement of tardive dyskinesia in our patient population as a whole. Favorable and unfavorable responses are discussed.

  12. Arm Tremor, Tardive Dyskinesia, and Mental Retardation.

    ERIC Educational Resources Information Center

    van Emmerik, R. E. A.; And Others

    1993-01-01

    The arm tremor of adults (n=32) diagnosed as having mental retardation and/or tardive dyskinesia was examined through an analysis of the acceleration properties of several arm postures. The degree of arm acceleration was increased in all subjects compared to a control group without mental retardation. Effects of neuroleptic medication were noted.…

  13. KINECT 3: A Phase 3 Randomized, Double-Blind, Placebo-Controlled Trial of Valbenazine for Tardive Dyskinesia.

    PubMed

    Hauser, Robert A; Factor, Stewart A; Marder, Stephen R; Knesevich, Mary Ann; Ramirez, Paul M; Jimenez, Roland; Burke, Joshua; Liang, Grace S; O'Brien, Christopher F

    2017-05-01

    Tardive dyskinesia is a persistent movement disorder induced by dopamine receptor blockers, including antipsychotics. Valbenazine (NBI-98854) is a novel, highly selective vesicular monoamine transporter 2 inhibitor that demonstrated favorable efficacy and tolerability in the treatment of tardive dyskinesia in phase 2 studies. This phase 3 study further evaluated the efficacy, safety, and tolerability of valbenazine as a treatment for tardive dyskinesia. This 6-week, randomized, double-blind, placebo-controlled trial included patients with schizophrenia, schizoaffective disorder, or a mood disorder who had moderate or severe tardive dyskinesia. Participants were randomly assigned in a 1:1:1 ratio to once-daily placebo, valbenazine at 40 mg/day, or valbenazine at 80 mg/day. The primary efficacy endpoint was change from baseline to week 6 in the 80 mg/day group compared with the placebo group on the Abnormal Involuntary Movement Scale (AIMS) dyskinesia score (items 1-7), as assessed by blinded central AIMS video raters. Safety assessments included adverse event monitoring, laboratory tests, ECG, and psychiatric measures. The intent-to-treat population included 225 participants, of whom 205 completed the study. Approximately 65% of participants had schizophrenia or schizoaffective disorder, and 85.5% were receiving concomitant antipsychotics. Least squares mean change from baseline to week 6 in AIMS dyskinesia score was -3.2 for the 80 mg/day group, compared with -0.1 for the placebo group, a significant difference. AIMS dyskinesia score was also reduced in the 40 mg/day group (-1.9 compared with -0.1). The incidence of adverse events was consistent with previous studies. Once-daily valbenazine significantly improved tardive dyskinesia in participants with underlying schizophrenia, schizoaffective disorder, or mood disorder. Valbenazine was generally well tolerated, and psychiatric status remained stable. Longer trials are necessary to understand the long-term effects

  14. Deanol in the treatment of tardive dyskinesia.

    PubMed

    Casey, D E; Denny, D

    1975-08-01

    A patient who developed severe tardive dyskinesia after the termination of long-term phenothiazine therapy was successfully treated with deanol, a possible precursor of acetylcholine. Physiological measurements were obtained to quantify the clinical course. The authors discuss the practical and heuristic implications of these observations and suggest further consideration of therapy directed toward enhancement of cholinergic activity in the central nervous system.

  15. Efficacy of piracetam in the treatment of tardive dyskinesia in schizophrenic patients: a randomized, double-blind, placebo-controlled crossover study.

    PubMed

    Libov, Igor; Miodownik, Chanoch; Bersudsky, Yuly; Dwolatzky, Tzvi; Lerner, Vladimir

    2007-07-01

    Piracetam is a potent antioxidant, a cerebral neuroprotector, a neuronal metabolic enhancer, and a brain integrative agent. More than 20 years ago, an intravenous preparation of piracetam demonstrated an improvement in the symptoms of tardive dyskinesia. The aim of our study was to reexamine the efficacy of piracetam in the treatment of tardive dyskinesia using an oral preparation. The study was conducted at the Be'er Sheva Mental Health Center from May 2003 to December 2004 and involved a 9-week, double-blind, crossover, placebo-controlled trial assessing 40 DSM-IV schizophrenic and schizo-affective patients with DSM-IV-TR tardive dyskinesia. All study subjects received their usual antipsychotic treatment. Initially, subjects were randomly assigned to receive 4 weeks of treatment with either piracetam (4800 mg/day) or placebo. Thereafter, following a washout period of 1 week, they entered the crossover phase of the study for a further 4 weeks. The change in score of the Extrapyramidal Symptom Rating Scale from baseline to the study endpoint was the primary outcome measure. The mean decrease in score from baseline to endpoint in the clinical global impression subscale in patients treated with piracetam was 1.1 points compared to 0.1 points in the placebo group (p = .004). The mean decrease in the tardive parkinsonism subscale was 8.7 points in patients treated with piracetam and 0.6 points in those on placebo (p = .001). The mean decrease in the tardive dyskinesia subscale was 3.0 points in the piracetam group in contrast to deterioration of condition in the placebo group by -0.2 points (p = .003). Piracetam appears to be effective in reducing symptoms of tardive dyskinesia. The specific mechanism by which piracetam may attenuate symptoms of tardive dyskinesia needs to be further evaluated. ClinicalTrials.gov identifier NCT00190008.

  16. Double-blind evaluation of deanol in tardive dyskinesia.

    PubMed

    Penovich, P; Morgan, J P; Kerzner, B; Karch, F; Goldblatt, D

    1978-05-12

    We administered deanol acetamidobenzoate, 2.0 g/day for four weeks, a double-blind, placebo-controlled crossover trial, to 14 patients with tardive dyskineasia. The patient population included both inpatients and outpatients. The response was evaluated by subjective clinical impression and scoring of filmed sequences. Patients' conditions improved significantly from baseline scores while receiving both deanol and placebo, but there was no distinction between the two treatments.

  17. NBI‐98854, a selective monoamine transport inhibitor for the treatment of tardive dyskinesia: A randomized, double‐blind, placebo‐controlled study

    PubMed Central

    Jimenez, Roland; Hauser, Robert A.; Factor, Stewart A.; Burke, Joshua; Mandri, Daniel; Castro‐Gayol, Julio C.

    2015-01-01

    ABSTRACT Background Tardive dyskinesia is a persistent movement disorder induced by chronic neuroleptic exposure. NBI‐98854 is a novel, highly selective, vesicular monoamine transporter 2 inhibitor. We present results of a randomized, 6‐week, double‐blind, placebo‐controlled, dose‐titration study evaluating the safety, tolerability, and efficacy of NBI‐98854 for the treatment of tardive dyskinesia. Methods Male and female adult subjects with moderate or severe tardive dyskinesia were included. NBI‐98854 or placebo was given once per day starting at 25 mg and then escalated by 25 mg to a maximum of 75 mg based on dyskinesia and tolerability assessment. The primary efficacy endpoint was the change in Abnormal Involuntary Movement Scale from baseline at week 6 scored by blinded, central video raters. The secondary endpoint was the Clinical Global Impression of Change—Tardive Dyskinesia score assessed by the blinded investigator. Results Two hundred five potential subjects were screened, and 102 were randomized; 76% of NBI‐98854 subjects and 80% of placebo subjects reached the maximum allowed dose. Abnormal Involuntary Movement Scale scores for NBI‐98854 compared with placebo were significantly reduced (p = 0.0005). Active drug was also superior on the Clinical Global Impression of Change—Tardive Dyskinesia (p < 0.0001). Treatment‐emergent adverse event rates were 49% in the NBI‐98854 and 33% in the placebo subjects. The most common adverse events (active vs. placebo) were fatigue and headache (9.8% vs. 4.1%) and constipation and urinary tract infection (3.9% vs. 6.1%). No clinically relevant changes in safety assessments were noted. Conclusion NBI‐98854 significantly improved tardive dyskinesia and was well tolerated in patients. These results support the phase 3 clinical trials of NBI‐98854 now underway. © 2015 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder

  18. NBI-98854, a selective monoamine transport inhibitor for the treatment of tardive dyskinesia: A randomized, double-blind, placebo-controlled study.

    PubMed

    O'Brien, Christopher F; Jimenez, Roland; Hauser, Robert A; Factor, Stewart A; Burke, Joshua; Mandri, Daniel; Castro-Gayol, Julio C

    2015-10-01

    Tardive dyskinesia is a persistent movement disorder induced by chronic neuroleptic exposure. NBI-98854 is a novel, highly selective, vesicular monoamine transporter 2 inhibitor. We present results of a randomized, 6-week, double-blind, placebo-controlled, dose-titration study evaluating the safety, tolerability, and efficacy of NBI-98854 for the treatment of tardive dyskinesia. Male and female adult subjects with moderate or severe tardive dyskinesia were included. NBI-98854 or placebo was given once per day starting at 25 mg and then escalated by 25 mg to a maximum of 75 mg based on dyskinesia and tolerability assessment. The primary efficacy endpoint was the change in Abnormal Involuntary Movement Scale from baseline at week 6 scored by blinded, central video raters. The secondary endpoint was the Clinical Global Impression of Change-Tardive Dyskinesia score assessed by the blinded investigator. Two hundred five potential subjects were screened, and 102 were randomized; 76% of NBI-98854 subjects and 80% of placebo subjects reached the maximum allowed dose. Abnormal Involuntary Movement Scale scores for NBI-98854 compared with placebo were significantly reduced (p = 0.0005). Active drug was also superior on the Clinical Global Impression of Change-Tardive Dyskinesia (p < 0.0001). Treatment-emergent adverse event rates were 49% in the NBI-98854 and 33% in the placebo subjects. The most common adverse events (active vs. placebo) were fatigue and headache (9.8% vs. 4.1%) and constipation and urinary tract infection (3.9% vs. 6.1%). No clinically relevant changes in safety assessments were noted. NBI-98854 significantly improved tardive dyskinesia and was well tolerated in patients. These results support the phase 3 clinical trials of NBI-98854 now underway. © 2015 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

  19. Molindone compared to haloperidol in a guinea-pig model of tardive dyskinesia.

    PubMed

    Koller, W; Curtin, J; Fields, J

    1984-10-01

    Molindone was compared with haloperidol in animal models of tardive dyskinesia. Treatment with molindone for 14 days at 3, 6, 20 and 40 mg/kg, enhanced the stereotyped behavioral response induced by apomorphine and increased the numbered of D-2 dopamine receptors in the striatum (Bmax) labelled by high affinity (Kd = 40 pmol) binding or [3H] spiroperidol in the guinea-pig. Molindone at 1 mg/kg, caused no behavioral supersensitivity or change in the binding of dopamine receptors. Chronic administration of haloperidol (0.1, 0.5 and 5.0 mg/kg) also increased both the behavioral response to apomorphine and the number of dopamine receptors. Haloperidol, at 0.02 and 0.004 mg/kg, had no effect. Molindone potentiated dopaminergic activity in animal models in a similar way to other neuroleptics, suggesting that its use may also result in tardive dyskinesia.

  20. Deanol in the treatment of tardive dyskinesia.

    PubMed

    Simpson, G M; Voitashevsky, A; Young, M A; Lee, J H

    1977-05-09

    Ten hospitalized chronic psychotic patients with symptoms of tardive dyskinesia were given deanol and placebo, each for 8 weeks following a double-bline, crossover design. No psychotropic agents were administered during the trial. Improvement occurred in all patients during the first treatment phase regardless of which drug the patients received; seven patients were on deanol and three on placebo during this time. The possible reasons for this decrease were discussed. It was concluded that deanol may have contributed to the decline but that its effect on the disorder was not dramatic.

  1. Tardive or Atypical Tourette's Disorder in a Population with Down Syndrome?

    ERIC Educational Resources Information Center

    Myers, Beverly; Pueschel, Siegfried M.

    1995-01-01

    In a population of 425 individuals with Down's syndrome, 5 persons (1.2%) were identified as having Tourette's disorder. The lack of interrelationship between Down's syndrome and Tourette's disorder argues against an atypical Tourette's disorder. Diagnoses of tardive Tourette's disorder were based on absence of family history of Tourette's, late…

  2. VMAT2 Inhibitors: New Drugs for the Treatment of Tardive Dyskinesia.

    PubMed

    Kim, Anne P; Baker, Danial E; Levien, Terri L

    2018-04-01

    To provide a review of tardive dyskinesia (TD) symptoms, etiology, pathophysiology, and treatments. PubMed, Web of Science, ClinicalTrials. gov, and Google Scholar were searched for relevant literature using a combination of the following terms: tardive dyskinesia, treatment, management, guidelines, tetrabenazine, deutetrabenazine, and valbenazine. Sources were limited to human data. Articles were reviewed for relevance to TD therapy. Reference lists were manually searched for other relevant articles. Selected literature was published between 1968 and 2017. This article reviews treatment options available for patients with TD. Many agents have been tried off-label to manage symptoms, with limited evidence of benefit. The Food and Drug Administration approved the first drug to treat TD valbenazine on April 11, 2017. TD is largely iatrogenic. Valbenazine's approval by the Food and Drug Administration was followed by the approval of deutetrabenazine, a drug with similar mechanism of action. Further data from postmarketing studies will be needed to verify that valbenazine's adverse effect profile is different from the profiles of tetrabenazine and deutetrabenazine.

  3. A quantitative measure of handwriting dysfluency for assessing tardive dyskinesia.

    PubMed

    Caligiuri, Michael P; Teulings, Hans-Leo; Dean, Charles E; Lohr, James B

    2015-04-01

    Tardive dyskinesia (TD) is a movement disorder commonly associated with chronic exposure to antidopaminergic medications, which may be in some cases disfiguring and socially disabling. The consensus from a growing body of research on the incidence and prevalence of TD in the modern era of antipsychotics indicates that this disorder has not disappeared continues to challenge the effective management of psychotic symptoms in patients with schizophrenia. A fundamental component in an effective strategy for managing TD is its reliable and accurate assessment. In the present study, we examined the clinical utility of a brief handwriting dysfluency measure for quantifying TD. Digitized samples of handwritten circles and loops were obtained from 62 psychosis patients with or without TD and from 50 healthy subjects. Two measures of dysfluent pen movements were extracted from each vertical pen stroke, including normalized jerk and the number of acceleration peaks. Tardive dyskinesia patients exhibited significantly higher dysfluency scores than non-TD patients and controls. Severity of handwriting movement dysfluency was correlated with Abnormal Involuntary Movement Scale severity ratings for some tasks. The procedure yielded high degrees of test-retest reliability. These results suggest that measures of handwriting movement dysfluency may be particularly useful for objectively evaluating the efficacy of pharmacotherapeutic strategies for treating TD.

  4. [Treatment with dimethylaminoethanol (deanol) in neuroleptic induced tardive dyskinesia].

    PubMed

    Kocher, R; Hobi, V; Linder, M; Studer, K

    1980-01-01

    A double blind cross-over study of 20 patients wiht tardive dyskinesia due to chronic use of neuroleptics showed no difference between efficacity of Deanol (Deaner) and placebo. Several patients improved with Deanol (Deaner), whereas several other patients showed increasing dyskinesia. The same phenomenon could be observed in the placebo group. Tolerance of the compound was very good. Results of an additional open study however suggest that the administration of Deanol (Deaner) may be tried as long as no other means are available to define those patients who will react favorably to this medication.

  5. Double blind controlled trial of deanol in tardive dyskinesia.

    PubMed

    George, J; Pridmore, S; Aldous, D

    1981-03-01

    Thirty three chronic psychiatric hospital subjects with oral tardive dyskinesia were divided into three groups. The subjects were matched for severity of symptoms then randomly assigned to treatment with a placebo, 1 g deanol or 2 g deanol per day. Statistical analysis showed that after 30 days treatment, there was a significant reduction in the mean rating of the movements of the group of 11 subjects on 2 g deanol per day. Six of these subjects showed substantial reduction in movement. Further studies using this dosage of deanol are unwarranted.

  6. Tardive Dyskinesia, Oral Parafunction, and Implant-Supported Rehabilitation.

    PubMed

    Lumetti, S; Ghiacci, G; Macaluso, G M; Amore, M; Galli, C; Calciolari, E; Manfredi, E

    2016-01-01

    Oral movement disorders may lead to prosthesis and implant failure due to excessive loading. We report on an edentulous patient suffering from drug-induced tardive dyskinesia (TD) and oral parafunction (OP) rehabilitated with implant-supported screw-retained prostheses. The frequency and intensity of the movements were high, and no pharmacological intervention was possible. Moreover, the patient refused night-time splint therapy. A series of implant and prosthetic failures were experienced. Implant failures were all in the maxilla and stopped when a rigid titanium structure was placed to connect implants. Ad hoc designed studies are desirable to elucidate the mutual influence between oral movement disorders and implant-supported rehabilitation.

  7. Tardive Dyskinesia, Oral Parafunction, and Implant-Supported Rehabilitation

    PubMed Central

    Amore, M.

    2016-01-01

    Oral movement disorders may lead to prosthesis and implant failure due to excessive loading. We report on an edentulous patient suffering from drug-induced tardive dyskinesia (TD) and oral parafunction (OP) rehabilitated with implant-supported screw-retained prostheses. The frequency and intensity of the movements were high, and no pharmacological intervention was possible. Moreover, the patient refused night-time splint therapy. A series of implant and prosthetic failures were experienced. Implant failures were all in the maxilla and stopped when a rigid titanium structure was placed to connect implants. Ad hoc designed studies are desirable to elucidate the mutual influence between oral movement disorders and implant-supported rehabilitation. PMID:28050290

  8. [Deanol in tardive dyskinesia: a double-blind study (author's transl)].

    PubMed

    Bockenheimer, S; Lucius, G

    1976-09-17

    Tardive dyskinesia following long-term application of neuroleptics is resistant to treatment. According to the hypothesis of a relative central nervous system acetylcholine lack as the underlying mechanism 20 patients were treated with dimethylaminoethanol (Deanol) in a double-blind study. Deanol is known to be a direct precursor of intracerebral acetylcholine. For several reasons (which are discussed) the data of but 11 patients were statistically evaluated. The results suggest some therapeutic effect in some of the patients only (significant improvement of oral hyperkinesia).

  9. Valbenazine for Tardive Dyskinesia.

    PubMed

    Freudenreich, Oliver; Remington, Gary

    Tardive dyskinesia (TD) remains a clinical concern for any patient who receives an antipsychotic. While the overall risk of developing TD is lower with newer antipsychotics compared to older agents, a significant number of patients who require long-term treatment will develop TD. Recently, valbenazine (brand name Ingrezza) became the first drug to be approved by the FDA specifically for the treatment of TD. In this New Drug Review, we summarize the basic pharmacology and clinical trial results for valbenazine. Valbenazine is a modified metabolite of the vesicular monoamine transporter 2 (VMAT-2) inhibitor tetrabenazine, which is approved for the treatment of the hyperkinetic movement disorder, Huntington's disease. In short-term clinical trials, valbenazine at a dose of 80 mg/day improved TD, with an effect size that is clinically significant (d=0.90). The effect size for the 40-mg/day dose was lower (d=0.52). Compared to tetrabenazine, valbenazine has better clinical characteristics (i.e., once-a-day dosing, better short-term side effect profile). However, only long-term experience in routine clinical populations can delineate valbenazine's full benefits, optimal dosing, and risks not identified during short-term registration trials.

  10. The Effects of Valbenazine in Participants with Tardive Dyskinesia: Results of the 1-Year KINECT 3 Extension Study.

    PubMed

    Factor, Stewart A; Remington, Gary; Comella, Cynthia L; Correll, Christoph U; Burke, Joshua; Jimenez, Roland; Liang, Grace S; O'Brien, Christopher F

    Valbenazine, a highly selective vesicular monoamine transporter 2 inhibitor, is approved for the treatment of tardive dyskinesia. This is the first report of long-term effects in adults with tardive dyskinesia. Participants with a DSM-IV diagnosis of schizophrenia, schizoaffective disorder, or a mood disorder who completed the 6-week, double-blind, placebo-controlled period of KINECT 3 were eligible to enter the 42-week valbenazine extension (VE) period and subsequent 4-week washout period. The extension phase was conducted from December 16, 2014, to August 3, 2016. Participants who received placebo and entered the VE period were re-randomized 1:1 to valbenazine 80 or 40 mg while others continued valbenazine at the KINECT 3 dose. Safety assessments included treatment-emergent adverse events (TEAEs) and scales for suicidal ideation/behavior, treatment-emergent akathisia or parkinsonism, and psychiatric symptoms. Efficacy assessments included the Abnormal Involuntary Movement Scale (AIMS) and Clinical Global Impression of Change-Tardive Dyskinesia (CGI-TD). 198 participants entered the VE period, 124 (62.6%) completed treatment (week 48), and 121 (61.1%) completed the follow-up visit after washout (week 52). During the VE period, 69.2% of participants had ≥ 1 TEAE, 14.6% had a serious TEAE, and 15.7% discontinued due to a TEAE. During washout, 13.1% of participants experienced a TEAE. No apparent risk for suicidal ideation or behavior was found. Long-term valbenazine treatment did not appear to induce or worsen akathisia or parkinsonism. Participants generally remained psychiatrically stable during the study. AIMS and CGI-TD measures indicated sustained tardive dyskinesia improvement, with scores returning toward baseline after 4 weeks of valbenazine washout. The long-term safety and tolerability of valbenazine were generally favorable, and maintenance of treatment effect was apparent with both doses during this long-term study. ClinicalTrials.gov identifier: NCT

  11. Updating the recommendations for treatment of tardive syndromes: A systematic review of new evidence and practical treatment algorithm.

    PubMed

    Bhidayasiri, Roongroj; Jitkritsadakul, Onanong; Friedman, Joseph H; Fahn, Stanley

    2018-06-15

    Management of tardive syndromes (TS) is challenging, with only a few evidence-based therapeutic algorithms reported in the American Academy of Neurology (AAN) guideline in 2013. To update the evidence-based recommendations and provide a practical treatment algorithm for management of TS by addressing 5 questions: 1) Is withdrawal of dopamine receptor blocking agents (DRBAs) an effective TS treatment? 2) Does switching from typical to atypical DRBAs reduce TS symptoms? 3) What is the efficacy of pharmacologic agents in treating TS? 4) Do patients with TS benefit from chemodenervation with botulinum toxin? 5) Do patients with TS benefit from surgical therapy? Systematic reviews were conducted by searching PsycINFO, Ovid MEDLINE, PubMed, EMBASE, Web of Science and Cochrane for articles published between 2012 and 2017 to identify new evidence published after the 2013 AAN guidelines. Articles were classified according to an AAN 4-tiered evidence-rating scheme. To the extent possible, for each study we attempted to categorize results based on the description of the population enrolled (tardive dyskinesia [TD], tardive dystonia, tardive tremor, etc.). Recommendations were based on the evidence. New evidence was combined with the existing guideline evidence to inform our recommendations. Deutetrabenazine and valbenazine are established as effective treatments of TD (Level A) and must be recommended as treatment. Clonazepam and Ginkgo biloba probably improve TD (Level B) and should be considered as treatment. Amantadine and tetrabenazine might be considered as TD treatment (Level C). Pallidal deep brain stimulation possibly improves TD and might be considered as a treatment for intractable TD (Level C). There is insufficient evidence to support or refute TS treatment by withdrawing causative agents or switching from typical to atypical DRBA (Level U). Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Les facteurs prédictifs de morbimortalité chez les patients sous ballon de contre pulsion intra-aortique en chirurgie cardiaque

    PubMed Central

    Elahmadi, Brahim; Motiaa, Youssef; Hatim, Abdedaim Elghadbane; Atmani, Noureddine; Moutakillah, Younes; Wahid, Fouad Amal; Elbekkali, Youssef; Houssa, Mahdi Ait; Razine, Rachid; Boulahya, Abdelatif; Drissi, Mohammed

    2015-01-01

    Le ballon de contre pulsion intra-aortique (BCPIA) est fréquemment utilisé en chirurgie cardiaque, comme moyen d'assistance circulatoire en cas de bas débit cardiaque. Il est d'intérêt clinique de déterminer les facteurs pronostiques chez les patients porteurs d'un BCPIA en chirurgie cardiaque, et qui restent un sujet rarement élucidé dans la littérature. L'objectif de notre travail est de déterminer les facteurs prédictifs de morbi-mortalité chez les patients sous ballon de contre pulsion intraortique en périopératoire d'une chirurgie cardiaque. Il s'agit d'une étude rétrospective portant sur l'ensemble des patients opérés en chirurgie cardiaque sous circulation extracorporelle, et ayant bénéficiés de la mise en place d'un ballon de contre pulsion intra-aortique en périopératoire, au service de chirurgie cardiovasculaire de l'Hôpital Militaire Mohamed V de Rabat, entre le mois de janvier 2005 et le mois d'aout 20014. Soixante dix patients ont été inclus dans notre étude. En analyse univariée l'âge, la dyspnée de stade III et IV, l'insuffisance cardiaque, la présence d'un infarctus du myocarde, d'une coronaropathie mono et bitronculaire, les anomalies du doppler de trons supra-aortique et du membre inférieur, le caractère urgent de la chirurgie, la durée de la circulation extracorporelle, l'instabilité hémodynamique postopératoire, le saignement et l'insuffisance rénale postopératoire étaient statistiquement associés à une mortalité postopératoire élevée. La dyskinésie préopératoire et la sortie de circulation extracorporelle sous drogues étaient associées à une morbidité globale élevée. En analyse multi variée, seule l'âge, constituait un facteur de risque indépendant de mortalité dans notre série avec un Odds Ratio (OR): 1,89 ; un Intervalle de Confiance (IC) 95% de (1,52-4,97) et un p =0,045. Au terme de notre étude, le taux de mortalité était de 48,57% et de morbidité globale était de 87,1%. Il

  13. Valbenazine for the treatment of tardive dyskinesia.

    PubMed

    Barquero, N

    2016-12-01

    Valbenazine (NBI-98854, Ingrezza) is a highly selective vesicular monoamine transporter 2 (VMAT2) inhibitor that modulates dopamine release during nerve communication. The pharmacological target VMAT2 may play an important role in the treatment of tardive dyskinesia (TD), an iatrogenic condition associated with the administration of antipsychotic medication for long periods and characterized by rapid, repetitive, stereotypic, involuntary movements of the face and extremities. There are currently no Food and Drug Administration (FDA)-approved drugs for the treatment of TD. Results of clinical trials have shown a distinctive improvement in TD symptoms during valbenazine administration and a new drug application submitted to the FDA in August 2016 is undergoing priority review with a decision expected in April 2017. Copyright 2016 Prous Science, S.A.U. or its licensors. All rights reserved.

  14. Current cannabis use and tardive dyskinesia.

    PubMed

    Zaretsky, A; Rector, N A; Seeman, M V; Fornazzari, X

    1993-12-01

    The aim of this study was to examine the relationship between substance abuse and tardive dyskinesia (TD) in 51 chronic, neuroleptic-treated, community outpatients with a DSM-III-R diagnosis of schizophrenia. In the presence of a clinical researcher, subjects completed a questionnaire on past and current alcohol and drug use, and provided information pertaining to variables which have, in the past, been implicated in the development of TD: smoking habits, caffeine consumption, and current neuroleptic dose. Subjects were also administered the Abnormal Involuntary Movement Scale (AIMS) in an interview format with either two or three trained raters present in the room. Consistent with previous reports, our results indicated a trend for females and older patients with a longer duration of illness to show elevated scores on the AIMS. In a hierarchical multiple regression analysis, however, cannabis use was found to correlate best with the presence of TD, out-ranking other putative factors.

  15. Genetics of tardive dyskinesia: Promising leads and ways forward.

    PubMed

    Zai, Clement C; Maes, Miriam S; Tiwari, Arun K; Zai, Gwyneth C; Remington, Gary; Kennedy, James L

    2018-06-15

    Tardive dyskinesia (TD) is a potentially irreversible and often debilitating movement disorder secondary to chronic use of dopamine receptor blocking medications. Genetic factors have been implicated in the etiology of TD. We therefore have reviewed the most promising genes associated with TD, including DRD2, DRD3, VMAT2, HSPG2, HTR2A, HTR2C, and SOD2. In addition, we present evidence supporting a role for these genes from preclinical models of TD. The current understanding of the etiogenesis of TD is discussed in the light of the recent approvals of valbenazine and deutetrabenazine, VMAT2 inhibitors, for treating TD. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Beneficial effect of candesartan and lisinopril against haloperidol-induced tardive dyskinesia in rat.

    PubMed

    Thakur, Kuldeep Singh; Prakash, Atish; Bisht, Rohit; Bansal, Puneet Kumar

    2015-12-01

    Tardive dyskinesia is a serious motor disorder of the orofacial region, resulting from chronic neuroleptic treatment of schizophrenia. Candesartan (AT1 antagonist) and lisinopril (ACE inhibitor) has been reported to possess antioxidant and neuroprotective effects. The present study is designed to investigate the effect of candesartan and lisinopril on haloperidol-induced orofacial dyskinesia and oxidative damage in rats. Tardive dyskinesia was induced by administering haloperidol (1 mg/kg i.p.) and concomitantly treated with candesartan (3 and 5 mg/kg p.o.) and lisinopril (10 and 15 mg/kg p.o.) for 3 weeks in male Wistar rats. Various behavioral parameters were assessed on days 0, 7, 14 and 21 and biochemical parameters were estimated at day 22. Chronic administration of haloperidol significantly increased stereotypic behaviors in rats, which were significantly improved by administration of candesartan and lisinopril. Chronic administration of haloperidol significantly increased oxidative stress and neuro-inflammation in the striatum region of the rat's brain. Co-administration of candesartan and lisinopril significantly attenuated the oxidative damage and neuro-inflammation in the haloperidol-treated rat. The present study supports the therapeutic use of candesartan and lisinopril in the treatment of typical antipsychotic-induced orofacial dyskinesia and possible antioxidant and neuro-inflammatory mechanisms. © The Author(s) 2014.

  17. Successful Treatment of Severe Tardive Dyskinesia with Valbenazine, Including a Patient’s Perspective

    PubMed Central

    Josiassen, Richard C.; Filmyer, Dawn M.; Gillean, Jack; Shah, Syed Sikandar; Dietterich, Tyler E.; Shaughnessy, Rita A.

    2017-01-01

    Patient: Female, 49 Final Diagnosis: Tardive dyskinesia Symptoms: Dyskinesia • dystonia Medication: — Clinical Procedure: Oral valbenazine Specialty: Psychiatry Objective: Unusual clinical course Background: Tardive dyskinesia (TD) is a chronic involuntary movement disorder frequently induced by dopamine receptor blockers, particularly first-generation antipsychotics. Until recently, management of TD was restricted to lowering the dose of the current medication, switching to another medication, or using off-label treatments with insufficient evidence of efficacy. Valbenazine, a vesicular monoamine transporter-2 (VMAT2) inhibitor, became the first drug to be approved by the FDA specifically for the treatment of TD. Case Report: We describe the case of a 49-year-old African-American woman who was diagnosed with bipolar disorder at the age of 34 and treated with lithium carbonate (900 mg daily) and citalopram (10 mg daily). She also received low doses of second-generation antipsychotics for weeks at a time, but these were always discontinued due to severe sedation. Over a decade later, at the age of 45, she experienced rapid onset of severe TD symptoms. She enrolled in a phase III double-blind clinical trial and received valbenazine 80 mg, with encouraging results. Conclusions: Once-daily dosing of valbenazine (80 mg) was effective and safe over a long period, even in this atypical case of severe and rapid-onset TD. PMID:29114100

  18. Anesthésie d’un greffé cardiaque en chirurgie non cardiaque: à propos d’un cas clinique et revue de la littérature

    PubMed Central

    Nassirou, Oumarou Mahamane Mamane; Jaafari, Abdelhamid; Chlouchi, Abdellatif; Bensghir, Mustapha; Haimeur, Charki

    2016-01-01

    Le nombre et la durée de survie des patients transplantés cardiaque sont en augmentation. Une partie de ces patients se présentent régulièrement pour une chirurgie générale en dehors de la transplantation cardiaque. L’anesthésie chez ces patients peut être difficile en raison des particularités physiologiques du cœur dénervé et de la gestion du traitement immunosuppresseur avec le risque de rejet et d’infection. Nous discutons la prise en charge anesthésique à travers un cas d’un patient âgé de 60 ans transplanté cardiaque devant subir une chirurgie de cure d’éventration abdominale et une revue de la littérature. PMID:28154639

  19. PERSONAL RECOLLECTIONS OF DR. HANS SELYE AND OF HIS INSTITUT DE MèDECINE ET DE CHIRURGIE EXPèRIMENTALES (IMCE).

    PubMed

    Salas-Prato, Milagros

    2014-03-30

    This article is a short personal recollection of Dr. Hans Selye (HS) and of his institute in order to show, first, why and how he influenced us; second, who he was as a person, human being, physician, scientist, professor, mentor; third, what was the structure and functioning of the Institut de Mèdecine et Chirurgie Expèrimentales (IMCE) and fourth, what HS' contributions and accomplishments were.

  20. L'endométriose pariétale cicatricielle après césarienne: une entité rare

    PubMed Central

    El Fahssi, Mohammed; Lomdo, Massama; Bounaim, Ahmed; Ali, Abdelmounaim Ait; Sair, Khalid

    2016-01-01

    L'endométriose de la paroi est une entité clinique rare, dont la physiopathologie demeure imprécise. Elle survient le plus souvent après une intervention chirurgicale gynécologique ou obstétricale. Nous rapportons le cas d'une patiente présentant une douleur cyclique, au niveau de la cicatrice de césarienne, Avec à l'examen clinique une masse de 5cm localisée au niveau de la fosse iliaque droite. la tomodensitométrie montre une masse de densité tissulaire de 45mm de grand axe. D'où la décision d'excision large de la lésion dont l’étude anatomopathologique confirme le diagnostic d'endométriose pariétale. Les suites postopératoires étaient simples avec un recul de 20 mois sans récidive de la masse ni de la douleur. A travers notre cas, nous insisterons sur les caractéristiques de cette pathologie, ce qui permettra au praticien de comprendre l'intérêt du diagnostic et de la prise en charge précoce de cette affection ainsi que la possibilité de sa prévention au cours de chaque chirurgie gynécologique ou obstétricale. PMID:27642418

  1. Instrumentation optique pour l'identification per-operatoire des tissus durant les chirurgies de la thyroide

    NASA Astrophysics Data System (ADS)

    De Montigny, Etienne

    Cette these traite du developpement d'instrumentation pour l'imagerie medicale optique. Ces travaux sont centres sur une application particuliere ; faciliter l'identification des tissus durant les chirurgies de la thyroide et de la parathyroide. La thyroide est une glande situee dans le cou, attachee au larynx a la hauteur de la pomme d'Adam. Elle est entouree de plusieurs structures importantes : muscles, nerfs et glandes parathyroides. Ces dernieres controlent la calcemie et jouent donc un role essentiel dans le corps. Elles sont toutefois de petite taille et sont tres difficiles a distinguer du gras et des ganglions environnants. L'objectif principal de cette these est de developper une instrumentation basee sur la microscopie optique pour permettre l'identification des tissus : thyroide, parathyroide, gras et ganglions, durant les chirurgies. Les choix sont donc faits en fonction de cette application et du contexte specifique des mesures intra-operatoires sur des patients humains. Plusieurs modalites d'imagerie optique sont identifiees pour atteindre l'objectif : microscopie confocale en reflectance, tomographique par coherence optique, et mesure de l'autofluorescence des glandes parathyroides. Dans le but d'ameliorer leur compatibilite avec l'environnement clinique qui requiert stabilite dans le temps et resistance aux vibrations et aux conditions environnementales, ce projet se concentre sur les implementations miniaturisables et basees sur des fibres optiques. Pour implementer un systeme d'imagerie en fluorescence a balayage laser rapide, un systeme d'imagerie en fluorescence par encodage spectral est propose. Bien que l'utilisation de l'encodage spectral semble a priori incompatible avec le contraste en fluorescence, une implementation facile a realiser est proposee. Une seconde version du montage, compatible avec la clinique et facilitant le developpement d'un endoscope, est presentee. La preuve de principe de cette methode est faite a 1300nm, une longueur

  2. Syndrome d'interruption de la tige pituitaire à révélation tardive

    PubMed Central

    Marmouch, Héla; Graja, Samah; Arfa, Sondes; Boubaker, Fadia; Khochtali, Ines

    2016-01-01

    Le syndrome d'interruption de la tige pituitaire est une cause assez fréquente de déficit en hormone de croissance et d'hypopituitarisme souvent révélé pendant la période néonatale et l'enfance. Cette observation illustre les particularités d'une révélation tardive de ce syndrome. Il s'agit d'une patiente âgée de 17ans hospitalisée pour aménorrhée primaire et impubérisme. Elle n'a pas d'antécédent d'incident néonatal. L'examen clinique révèle un retard de croissance sévère. L'hypophysiogramme a montré un hypopituitarisme complet sans diabète insipide. L'imagerie par résonnance magnétique a montré une interruption de la tige pituitaire avec une post hypophyse ectopique. Une malformation rénale a été objectivée, ce qui est en faveur d'une origine congénitale malformative de ce syndrome. Une substitution hormonale a été administrée à cette patiente. Cette forme clinique tardive souligne la nécessité de diagnostic précoce d'impubérisme et/ou de retard de croissance révélant une pathologie à potentiel de gravité important. PMID:27231511

  3. Treatment of tardive dyskinesia with tetrabenazine or valbenazine: a systematic review.

    PubMed

    Caroff, Stanley N; Aggarwal, Saurabh; Yonan, Charles

    2018-02-01

    Up to 30% of patients taking antipsychotics may develop tardive dyskinesia (TD). Recent evidence-based recommendations demonstrate an unmet need for effective TD management. This systematic review was designed to update the evidence for TD treatment, comparing two vesicular monoamine transporter 2 (VMAT2) inhibitors, tetrabenazine and valbenazine. Of 487 PubMed/Embase search results, 11 studies met the review criteria. Valbenazine efficacy was demonstrated in rigorously designed clinical trials that meet the guidelines for AAN Class I evidence. Due to differences in study designs and a lack of standardized and controlled trials with tetrabenazine, a formal meta-analysis comparing the agents was not possible. However, valbenazine appears to have fewer side effects and a more favorable once-daily dosing regimen for the treatment of TD.

  4. Qualité de vie et vécu de la maladie, avant et après hystérectomie vaginale, chez les femmes admises au Centre Hospitalier Universitaire de Brazzaville

    PubMed Central

    Mbongo, Jean Alfred; Mouanga, Alain; Miabaou, Didace Massamba; Nzelie, Aya; Iloki, Léon Hervé

    2016-01-01

    Toute maladie est un mal en soi qu’il faut éradiquer car elle altère souvent de façon significative la qualité de la vie. L’hystérectomie vaginale est indiquée pour les patientes qui présentent certaines affections gynécologiques graves, elle est donc bénéfique mais, peut également avoir une répercussion néfaste sur la qualité de vie de la femme. Ainsi nous avons voulu explorer le vécu de la maladie et de l’hystérectomie vaginale (HV) des femmes avant et après l’intervention chirurgicale. Nous avons effectué une étude prospective qualitative, à recueil clinique sur une période de 12 mois; qui a concerné les femmes, ayant subi une hystérectomie vaginale. Celles n’ayant pas accepté de participer à l’étude, ou n’ayant pas de contact téléphonique n’ont pas été incluses. Pendant la maladie, le vécu des femmes a été: l’inconfort sexuel 26/40 (65%); les saignements génitaux 12/40 (30%); les douleurs pelviennes 13/40 (32,5%). En Post-opératoire, ont été noté les dyspareunies transitoires30/40 (75%) ; les céphalées secondaires à l’anesthésie 4/40 (10%). Le vécu psychologique a été dominé avant l’HV par la peur de la chirurgie chez toutes les patientes, les troubles du sommeil 38/40 (95%), l’angoisse 30 /40(75%), un sentiment de honte lié aux difficultés à accomplir l’acte sexuel en raison du prolapsus 26/40(65%) et/ ou en raison des saignements génitaux, dus au fibrome utérin 14/40(35%). Le sentiment de la perte de féminité était déclaré par 26/40 femmes porteuses de prolapsus utérin (65%), la modification de l’estime de soi 26/40 (65%). Ces appréciations subjectives ont été améliorées avec l’HV, contre balançant la perte de leur organe de reproduction. Aucune information n’a été donnée par les femmes à leurs proches et aux membres de la famille avant la chirurgie, traduisant ainsi leur sentiment de gène ou de honte. L’arrêt des symptômes a été observé dans tous les

  5. Tardive Dyskinesia Prevalence in the Period of Second-Generation Antipsychotic Use: A Meta-Analysis.

    PubMed

    Carbon, Maren; Hsieh, Cheng-Hsi; Kane, John M; Correll, Christoph U

    2017-03-01

    Comparison of tardive dyskinesia (TD) prevalence during contemporaneous treatment with first-generation antipsychotics (FGAs) and/or second-generation antipsychotics (SGAs). PubMed/MEDLINE/Google Scholar search (January 1, 2000-September 30, 2015) without language restriction using (tardive dyskinesia OR tardive) AND (antipsychotic*) plus specific names of SGAs. Of 8,895 hits, we screened 203 full-text articles for cross-sectional, rating scale-based TD rates during SGA, FGA, or FGA+SGA treatment. Forty-one studies were used for random effects meta-analysis and meta-regression. Two authors independently extracted data on overall and antipsychotic class-wise TD rates and on TD moderators. The global mean TD prevalence was 25.3% (95% CI = 22.7%-28.1%) across all 41 studies (N = 11,493, mean age = 42.8 years, male = 66.4%, schizophrenia-spectrum disorders = 77.1%). TD prevalence varied greatly: Rates were lower with current SGA treatment (20.7%; 95% CI = 16.6%-25.4%, N = 5,103) vs current FGA treatment (30.0%; 95% CI = 26.4%-33.8%, N = 5,062; Q = 9.17, P = .002). This difference remained significant after controlling for moderators: higher age (Z = 2.85, P = .004; number of studies = 39 ) and region (39 studies; Asia vs Europe, Z = 1.55, P = .12; Asia lower than United States, Z = 2.6, P = .009; Asia lower than other regions, Z = 2.42, P = .015). Additional moderators of TD prevalence included longer illness duration (R² = 0.15; P = .03; 21 studies) and frequency of parkinsonism (R² = 0.23, P = .017; number of studies = 19). Particularly low TD prevalence (7.2%; number of studies = 4) was found in the treatment arms with FGA-naive subjects relative to SGA-treated cohorts with likely prior FGA exposure (23.4%; P < .001; 28 studies). Lower TD prevalence of SGA relative to FGA was also confirmed in the subgroup of studies reporting on ≥ 2 antipsychotic classes/combinations; this was found for both SGAs vs FGAs (risk ratio = 0.80; 95% CI = 0.67-0.95, Z = -2.55, P

  6. Valbenazine for the treatment of tardive dyskinesia.

    PubMed

    Seeberger, Lauren C; Hauser, Robert A

    2017-08-01

    Tardive dyskinesia (TD) is a hyperkinetic movement disorder that may result from treatment with antipsychotics or other dopamine receptor blocking agents. Underlying pathophysiology is incompletely understood but since the 1970s dopamine depleting agents have been used to reduce involuntary movements. The search for safe, effective treatments for TD is ongoing. Valbenazine, a novel VMAT2 inhibitor, has recently been FDA approved for treatment of TD. Areas covered: An overview of TD, unmet medical needs and current treatment guidelines are presented. The background, chemistry and clinical development of valbenazine to treat TD is detailed. A competitive market is developing as the treatment gap is identified and potential therapies are discussed in context of a broader market overview. Expert opinion: Antipsychotic use is growing among adults and children in the U.S. Consequently, prevalence of TD is expected to rise. Cessation of antipsychotics is often not possible as the psychiatric condition may deteriorate. Increasing doses of an antipsychotic to suppress involuntary movements is not sustainable long term as underlying TD worsens and movements typically recur. There were no FDA approved treatments for TD. The approval of valbenazine to treat TD is a critical step in addressing this gap in neurologic care.

  7. A comparison of masking effects of haloperidol versus molindone in tardive dyskinesia.

    PubMed

    Glazer, W M; Hafez, H

    1990-01-01

    An experimental method was utilized to compare the masking effects of two neuroleptic agents--molindone and haloperidol--on 18 neuroleptic-treated schizophrenic patients exhibiting operationally defined withdrawal-exacerbated tardive dyskinesia. After a week on one of these two medications at preestablished doses equivalent to that of the pre-study neuroleptic, molindone-masked total AIMS scores by significantly less (12%) than haloperidol (27%). Similarly, during a second week when the dose of these neuroleptics was equivalent to 200% that of the pre-study dose, molindone masked the total AIMS score significantly less (23%) as compared to haloperidol (53%). Several interpretations of this finding are considered. This study demonstrates the feasibility of a method that may offer a model for understanding pharmacological differences among neuroleptic medications.

  8. Deanol acetamidobenzoate (Deaner) in tardive dyskinesia.

    PubMed

    Stafford, J R; Fann, W E

    1977-12-01

    A total of twenty-nine patients have thus far been treated with deanol in various dosage levels for periods ranging from five to thirty days. Clinical response has been pronounced, even dramatic, in seven patients, moderate but significant in nine patients, and slight to insignificant in thirteen others. Videotape rating and quantitative accelerometry, to the extent that they constitute novel and stress-inducing experiences may not be representative of global clinical changes. Deanol did not produce the anticipated elevation in choline levels postulated to be one mechanism of its action. The failure of deanol to achieve this effect may most probably be attributed to interval after last dose, to inadequate level of deanol or to some alteration in choline metabolism in the presence of deanol. The etiology of tardive dyskinesia at biochemical and structural levels is complex. For some patients improvement has been dramatic and clearly associated with deanol. Others appear to exhibit minimal response which cannot be differentiated from placebo or environmental effects. Our present strategy, in common with that of other authors includes the administration of a "challenge" dose of rapid acting injectable cholinomimetic agents (e.g. physostigmine) and dopamine-blocking agents (e.g. haloperidol) with placebo controls. In this manner therapy may be more rationally selected for long-term use and may logically include deanol. The correlation of such predictive challenges with response to long-term treatment is an area for much more well controlled study.

  9. Valbenazine as the first and only approved treatment for adults with tardive dyskinesia.

    PubMed

    Sarva, Harini; Henchcliffe, Claire

    2018-03-01

    Valbenazine is a selective VMAT2 inhibitor that the FDA approved in April 2017 for the specific treatment of tardive dyskinesia (TD), a movement disorder commonly caused by dopamine blocking agents. Valbenazine acts to decrease dopamine release, reducing excessive movement found in TD. Areas covered: This drug profile reviews the development of valbenazine and the clinical trials that led to its approval as the first treatment specific to TD. The literature search was performed with the PubMed online database. Expert commentary: Two clinical trials assessing the efficacy of valbenazine have shown the reduction of antipsychotic-induced involuntary movement. No life threatening adverse effects were found. Data from a 42-week extension study demonstrated sustained response.

  10. Clinical management of tardive dyskinesia: Five steps to success.

    PubMed

    Citrome, Leslie

    2017-12-15

    Tardive dyskinesia (TD) has long been thought to be a generally irreversible consequence of the use of dopamine receptor blocking agents. There is now an opportunity to successfully manage this condition with agents approved by the US Food and Drug Administration. This is important because TD has not been eliminated with the use of second-generation antipsychotics, and the expansion of antipsychotics to treat conditions other than schizophrenia has resulted in millions of additional individuals at risk for developing TD. Recognition of TD requires careful observation; a structured approach using the Abnormal Involuntary Movement Scale is encouraged. Harm reduction can be achieved by using antipsychotics judiciously when possible and by paying attention to other modifiable risk factors such as drug-induced parkinsonian symptoms and the use of anticholinergic medication. Once TD has emerged and is associated with dysfunction or distress, treatment with a VMAT2 inhibitor such as deutetrabenazine or valbenazine is well supported by several controlled clinical trials. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. APR3 modulates oxidative stress and mitochondrial function in ARPE-19 cells.

    PubMed

    Li, Yuan; Zou, Xuan; Gao, Jing; Cao, Ke; Feng, Zhihui; Liu, Jiankang

    2018-05-24

    Impairment of retinal pigment epithelial (RPE) cells is considered a key contributor to the development of age-related macular degeneration. Apoptosis-related protein 3 (APR3) was recently discovered after treatment with all- trans retinoic acid, a pivotal molecule in RPE cells. However, the function of APR3 remains poorly understood. In the present study, we found that APR3 could interact with nuclear factor (erythroid-derived 2)-like 2, which is a regulator of phase II enzymes, and that knockdown of APR3 promoted nuclear factor (erythroid-derived 2)-like 2 nuclear translocation and activated expression of phase II enzymes, which was accompanied by improved redox status and mitochondrial activity. Overexpression of APR3 revealed its mitochondrial localization and induced a robust production of reactive oxygen species that was accompanied by impaired mitochondrial oxygen consumption, complex activity, and lower ATP content, resulting in significant changes in mitochondrial structure, which may contribute to cell apoptosis. High doses of all- trans retinoic acid treatment were found to significantly induce APR3 expression, increase reactive oxygen species levels, and decrease ATP content, which were abolished by knockdown of APR3. These results indicate that APR3 plays a vital role in regulating redox status and mitochondrial activity and thus suggest APR3 might be a potential novel target for study of treatment of age-related macular degeneration.-Li, Y., Zou, X., Gao, J., Cao, K., Feng, Z., Liu, J. APR3 modulates oxidative stress and mitochondrial function in ARPE-19 cells.

  12. Refractive Surgery: New Techniques and Usability for Military Personnel (La chirurgie refractive: Nouvelles techniques et leur application pour le personnel militaire)

    DTIC Science & Technology

    2012-11-01

    de loin sans correction, la chirurgie réfractive permet aux jeunes recrues ou militaires du rang de satisfaire aux normes de vision sans...correction exigées pour le métier militaire de leur choix, d’où une augmentation du nombre de candidats et la possibilité pour les individus...réfractive risquent d’engendrer des handicaps visuels et d’écourter des carrières militaires. Pour cette raison, la qualité du service fourni

  13. Medication-Induced Tardive Dyskinesia: A Review and Update

    PubMed Central

    Novitch, Matthew; Kaye, Alan David; Kata, Vijay; Kaye, Adam M.

    2017-01-01

    Background: Tardive dyskinesia (TD) is a movement disorder that causes involuntary, repetitive body movements and is commonly seen in patients who are on long-term treatment with antipsychotic medications. However, several other classes of medications with different mechanisms are also associated with TD. Methods: We conducted a PubMed search using keywords and combined word searches that involved medication-induced TD, as well as agents that are associated with causing or are used to treat medication-induced TD. We attempted to include as many recent (publication date of 2015 and later) articles as possible. Results: The reported incidence of TD seems to be reduced with the use of atypical antipsychotic drugs, yet the risk of developing TD remains with these medications. Furthermore, several other medication classes have a high prevalence of TD and yet are not commonly considered to be TD-inducing. This review highlights the need for a prevention-based focus of TD treatment that starts with a clinical consideration of pharmacologic choices related to each individual patient's history. Conclusion: This review offers the information current as of 2016 on the pathophysiology, etiology, and epidemiology of TD, as well as the medications associated with TD, mechanisms of medication-induced TD, and treatments for medication-induced TD. PMID:28638290

  14. The trauma registry compared to All Patient Refined Diagnosis Groups (APR-DRG).

    PubMed

    Hackworth, Jodi; Askegard-Giesmann, Johanna; Rouse, Thomas; Benneyworth, Brian

    2017-05-01

    Literature has shown there are significant differences between administrative databases and clinical registry data. Our objective was to compare the identification of trauma patients using All Patient Refined Diagnosis Related Groups (APR-DRG) as compared to the Trauma Registry and estimate the effects of those discrepancies on utilization. Admitted pediatric patients from 1/2012-12/2013 were abstracted from the trauma registry. The patients were linked to corresponding administrative data using the Pediatric Health Information System database at a single children's hospital. APR-DRGs referencing trauma were used to identify trauma patients. We compared variables related to utilization and diagnosis to determine the level of agreement between the two datasets. There were 1942 trauma registry patients and 980 administrative records identified with trauma-specific APR-DRG during the study period. Forty-two percent (816/1942) of registry records had an associated trauma-specific APR-DRG; 69% of registry patients requiring ICU care had trauma APR-DRGs; 73% of registry patients with head injuries had trauma APR-DRGs. Only 21% of registry patients requiring surgical management had associated trauma APR-DRGs, and 12.5% of simple fractures had associated trauma APR-DRGs. APR-DRGs appeared to only capture a fraction of the entire trauma population and it tends to be the more severely ill patients. As a result, the administrative data was not able to accurately answer hospital or operating room utilization as well as specific information on diagnosis categories regarding trauma patients. APR-DRG administrative data should not be used as the only data source for evaluating the needs of a trauma program. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Pratique anesthésique à Lubumbashi: indications, types de chirurgie et types de patient

    PubMed Central

    Kabey, Alain Kabey a; Lubanga, Muyumba; Tshamba, Mundongo; Kaut, Mukeng; Kakambal, Kaij; Muteya, Manika; Manzanza, Kilembe; Kalal, Kapend

    2015-01-01

    Introduction Cette étude a pour objectif de décrire la pratique anesthésique dans un pays à faible revenu et où le plateau technique anesthésique est moins équipé. Méthodes Une étude descriptive transversale a été menée durant l'année 2013. L'enquête a concerné les pratiques anesthésiques, les indications chirurgicales et les caractéristiques des malades. L'encodage et l'analyse des données ont été réalisées grâce aux logiciels Epi Info 3.5.3 et Excel 2010. Résultats Nous avons enregistré 2358 patients dont l’âge médian était de 29 + 15 ans, avec 81,5% âgés de 11 à 50 ans. Parmi eux, 67,3% des malades étaient du sexe féminin. Dans ensemble, 62,5% de ces patients étaient pris en charge pour les interventions programmées. L’évaluation du risque anesthésique a montré que 91,9% des patients étaient de la classe ASA I et II. La chirurgie la plus pratiquée était viscérale (46,7%) suivie de la chirurgie gynéco-obstétricale (29,2%). Les différents types d'anesthésie étaient les suivants: anesthésie générale (87,6%), locorégionale (11,8%) et combinée (0,6%). Conclusion La pratique anesthésique dans la population d’étude était dominée par l'anesthésie générale. Les malades étaient au trois quart de sexe féminin et de la classe ASA I et II. Les résultats de cette étude indiquent la nécessité d’évaluer l'issue de cette pratique. La pratique anesthésique à Lubumbashi est tributaire du plateau technique, des compétences du personnel et de l'acceptabilité du type d'anesthésie par les patients. PMID:26523180

  16. Epidemiology, Prevention, and Assessment of Tardive Dyskinesia and Advances in Treatment.

    PubMed

    Correll, Christoph U; Kane, John M; Citrome, Leslie L

    ​​ Tardive dyskinesia (TD) is a disorder characterized by involuntary movements, typically of the orofacial muscles and also of the extremities and other muscle groups. The condition is associated with exposure to dopamine receptor blocking agents, including antipsychotics. Because the indications and off-label uses for these agents have expanded over the last 2 decades, a larger number of patients are receiving antipsychotic medications than in the past. While evidence suggests that patients being treated with second-generation antipsychotics have less risk for developing TD than those treated with first-generation antipsychotics, the decreased risk is not as great as was originally expected. In addition, patients with chronic psychiatric conditions often require long-term use of antipsychotics, putting them at risk for TD. This article addresses the prevalence, risk factors, and prevention of TD; assessment strategies including diagnostic criteria and rating scales; and evidence for TD treatments, including 2 newly approved medications: deutetrabenazine and valbenazine. ​​​. © Copyright 2017 Physicians Postgraduate Press, Inc.

  17. Reliability enhancement of APR + diverse protection system regarding common cause failures

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

    Oh, Y. G.; Kim, Y. M.; Yim, H. S.

    2012-07-01

    The Advanced Power Reactor Plus (APR +) nuclear power plant design has been developed on the basis of the APR1400 (Advanced Power Reactor 1400 MWe) to further enhance safety and economics. For the mitigation of Anticipated Transients Without Scram (ATWS) as well as Common Cause Failures (CCF) within the Plant Protection System (PPS) and the Emergency Safety Feature - Component Control System (ESF-CCS), several design improvement features have been implemented for the Diverse Protection System (DPS) of the APR + plant. As compared to the APR1400 DPS design, the APR + DPS has been designed to provide the Safety Injectionmore » Actuation Signal (SIAS) considering a large break LOCA accident concurrent with the CCF. Additionally several design improvement features, such as channel structure with redundant processing modules, and changes of system communication methods and auto-system test methods, are introduced to enhance the functional reliability of the DPS. Therefore, it is expected that the APR + DPS can provide an enhanced safety and reliability regarding possible CCF in the safety-grade I and C systems as well as the DPS itself. (authors)« less

  18. Pharmacotherapy for the treatment of tardive dyskinesia in schizophrenia patients.

    PubMed

    Witter, Daniel P; Holbert, Richard C; Suryadevara, Uma

    2017-07-01

    Tardive dyskinesia (TD) is an iatrogenic movement disorder most commonly observed in patients with psychotic disorders who are treated with dopamine blocking antipsychotic medications. Treatment options are limited, and recommendations for treatment are based on a relative scarcity of evidence. Areas covered: After briefly highlighting current mechanistic theories of TD, this review will discuss the evidence for a number of medications of several different classes that have been studied for the treatment of TD since the 1970s with an emphasis on placebo controlled trials when possible. We used a Pubmed search of primary studies, reviews, and metaanalyses on the topic of TD treatment in order to cover this topic. Expert opinion: Treatment of TD is difficult given limited data and incomplete understanding of the mechanism. Treatment of TD must be evaluated on an individual basis with careful weight given to severity of symptoms. We suggest the use of atypical versus conventional antipsychotics whenever possible and would recommend trials with one or more of a number of additional agents starting with valbenazine.

  19. 78 FR 37531 - Agency Information Collection Activities; Comment Request; Annual Performance Reporting (APR...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-21

    ...; Comment Request; Annual Performance Reporting (APR) System for NIDRR Grantees (RERCs, RRTCS, FIPs, ARRTs... of Collection: Annual Performance Reporting (APR) System for NIDRR Grantees (RERCs, RRTCS, FIPs... requests an extension of the Annual Performance Reporting (APR) System for NIDRR Grantees (RERCs, RRTCS...

  20. Clinical risk factors for the development of tardive dyskinesia.

    PubMed

    Solmi, Marco; Pigato, Giorgio; Kane, John M; Correll, Christoph U

    2018-06-15

    Tardive dyskinesia (TD) is a severe condition that can affect almost 1 out of 4 patients on current or previous antipsychotic treatment, including both first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs). While two novel vesicular monoamine transporter inhibitors, deutetrabenazine and valbenazine, have shown acute efficacy for TD, the majority of patients do not remit, and TD appears to recur once treatment is withdrawn. Hence, prevention of TD remains a crucial goal. We provide a clinically oriented overview of risk factors for TD, dividing them into patient-, illness- and treatment-related variables, as well as nonmodifiable and modifiable factors. Unmodifiable patient-related and illness-related risk factors for TD include older age, female sex, white and African descent, longer illness duration, intellectual disability and brain damage, negative symptoms in schizophrenia, mood disorders, cognitive symptoms in mood disorders, and gene polymorphisms involving antipsychotic metabolism and dopamine functioning. Modifiable comorbidity-related and treatment-related factors include diabetes, smoking, and alcohol and substance abuse, FGA vs SGA treatment, higher cumulative and current antipsychotic dose or antipsychotic plasma levels, early parkinsonian side effects, anticholinergic co-treatment, akathisia, and emergent dyskinesia. Clinicians using dopamine antagonists need to consider risk factors for TD to minimize TD and its consequences. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. VMAT2 inhibitors for the treatment of tardive dyskinesia.

    PubMed

    Scorr, Laura M; Factor, Stewart A

    2018-06-15

    Tardive dyskinesia (TD) is an often disabling hyperkinetic movement disorder caused by exposure to dopamine receptor blocking agents. Although initially thought to most commonly occur with typical antipsychotics, the incidence is likely similar with atypical antipsychotics and antiemetics such as metoclopramide. Increased prescribing of these agents as well as low rates of remission have contributed to a rising prevalence of TD. Although this condition was described nearly 60 years ago, it is only within the past year that two novel therapeutic agents were FDA approved. Characterization of the VMAT2 inhibitor tetrabenazine, which was identified as a therapeutic agent for TD in older clinical trials, has yielded two distinct pharmacologic strategies to optimize response. The first strategy, used to create deutetrabenazine, employed deuterization of tetrabenazine to stabilize the pharmacokinetics and eliminate high peak plasma levels. The second strategy was the creation of a prodrug, valbenazine, for the two most active isoforms of tetrabenazine that also resulted in more stable pharmacokinetics and eliminated peak plasma levels. Both agents have been demonstrated to be effective and safe for the treatment of TD in multicenter, controlled trials and their development has led to a resurgence of interest in the characterization and treatment of this movement disorder. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Reprint of: Clinical management of tardive dyskinesia: Five steps to success.

    PubMed

    Citrome, Leslie

    2018-06-15

    Tardive dyskinesia (TD) has long been thought to be a generally irreversible consequence of the use of dopamine receptor blocking agents. There is now an opportunity to successfully manage this condition with agents approved by the US Food and Drug Administration. This is important because TD has not been eliminated with the use of second-generation antipsychotics, and the expansion of antipsychotics to treat conditions other than schizophrenia has resulted in millions of additional individuals at risk for developing TD. Recognition of TD requires careful observation; a structured approach using the Abnormal Involuntary Movement Scale is encouraged. Harm reduction can be achieved by using antipsychotics judiciously when possible and by paying attention to other modifiable risk factors such as drug-induced parkinsonian symptoms and the use of anticholinergic medication. Once TD has emerged and is associated with dysfunction or distress, treatment with a VMAT2 inhibitor such as deutetrabenazine or valbenazine is well supported by several controlled clinical trials. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Evaluating SPP/APR Improvement Activities

    ERIC Educational Resources Information Center

    National Early Childhood Technical Assistance Center (NECTAC), 2009

    2009-01-01

    This document is intended to assist State Education Agency (SEA) and Lead Agency (LA) staff and technical assistance providers in designing a meaningful evaluation for the State Performance Plan (SPP)/Annual Performance Report (APR) improvement activities. It provides: (1) information about the relevance of evaluation in the context of improvement…

  4. Tardive dyskinesia: 21st century may bring new treatments to a forgotten disorder.

    PubMed

    Rakesh, Gopalkumar; Muzyk, Andrew; Szabo, Steven T; Gupta, Sanjay; Pae, Chi-Un; Masand, Prakash

    2017-05-01

    Tardive dyskinesia (TD) is a condition that was first described nearly 60 years ago. Despite the tremendous amount of research on pathophysiology and numerous follow-up studies to understand the course and prognosis of TD, effective treatment of the condition continued to elude us until recently. We review and summarize clinical literature on TD, as well as provide an update on new treatments available. The emergence of tetrabenazine as a treatment modality decreased suffering and improved quality of life for patients. New agents such as valbenazine, deutetrabenazine, and branched-chain amino acids continue to provide relief to patients, without the troublesome side effects of tetrabenazine. There continues to be a substantial prevalence rate for the condition with the use of first-generation and second-generation antipsychotics. Because of the potential irreversible nature, legal implication, and high prevalence of TD, we advocate for more research on new treatments for the disorder.

  5. Evidence-based guideline: treatment of tardive syndromes: report of the Guideline Development Subcommittee of the American Academy of Neurology.

    PubMed

    Bhidayasiri, Roongroj; Fahn, Stanley; Weiner, William J; Gronseth, Gary S; Sullivan, Kelly L; Zesiewicz, Theresa A

    2013-07-30

    To make evidence-based recommendations regarding management of tardive syndromes (TDS), including tardive dyskinesias (TDD), by addressing 5 questions: 1) Is withdrawal of dopamine receptor blocking agents (DRBAs) an effective TDS treatment? 2) Does switching from typical to atypical DRBAs reduce TDS symptoms? 3) What is the efficacy of pharmacologic agents in treating TDS? 4) Do patients with TDS benefit from chemodenervation with botulinum toxin? 5) Do patients with TDS benefit from surgical therapy? PsycINFO, Ovid MEDLINE, EMBASE, Web of Science, and Cochrane were searched (1966-2011). Articles were classified according to a 4-tiered evidence-rating scheme; recommendations were tied to the evidence. Clonazepam probably improves TDD and ginkgo biloba probably improves TDS (both Level B); both should be considered as treatment. Risperidone may improve TDS but cannot be recommended as treatment because neuroleptics may cause TDS despite masking symptoms. Amantadine and tetrabenazine might be considered as TDS treatment (Level C). Diltiazem should not be considered as TDD treatment (Level B); galantamine and eicosapentaenoic acid may not be considered as treatment (Level C). Data are insufficient to support or refute use of acetazolamide, bromocriptine, thiamine, baclofen, vitamin E, vitamin B6, selegiline, clozapine, olanzapine, melatonin, nifedipine, fluperlapine, sulpiride, flupenthixol, thiopropazate, haloperidol, levetiracetam, quetiapine, ziprasidone, sertindole, aripiprazole, buspirone, yi-gan san, biperiden discontinuation, botulinum toxin type A, electroconvulsive therapy, α-methyldopa, reserpine, and pallidal deep brain stimulation as TDS treatments (Level U). Data are insufficient to support or refute TDS treatment by withdrawing causative agents or switching from typical to atypical DRBA (Level U).

  6. A Quantitative Measure of Handwriting Dysfluency for Assessing Tardive Dyskinesia

    PubMed Central

    Caligiuri, Michael P.; Teulings, Hans-Leo; Dean, Charles E.; Lohr, James B.

    2015-01-01

    Tardive dyskinesia (TD) is movement disorder commonly associated with chronic exposure to antidopaminergic medications which may be in some cases disfiguring and socially disabling. The consensus from a growing body of research on the incidence and prevalence of TD in the modern era of antipsychotics indicates that this disorder has not disappeared continues to challenge the effective management of psychotic symptoms in patients with schizophrenia. A fundamental component in an effective strategy for managing TD is its reliable and accurate assessment. In the present study, we examined the clinical utility of a brief handwriting dysfluency measure for quantifying TD. Digitized samples of handwritten circles and loops were obtained from 62 psychosis patients with or without TD and from 50 healthy subjects. Two measures of dysfluent pen movements were extracted from each vertical pen stroke, including normalized jerk and the number of acceleration peaks. TD patients exhibited significantly higher dysfluency scores than non-TD patients and controls. Severity of handwriting movement dysfluency was correlated with AIMS severity ratings for some tasks. The procedure yielded high degrees of test-retest reliability. These results suggest that measures of handwriting movement dysfluency may be particularly useful for objectively evaluating the efficacy of pharmacotherapeutic strategies for treating TD. PMID:25679121

  7. Exercise Limitation Imposed by an Approved Air Purifying Respirator (APR)

    DTIC Science & Technology

    2010-05-01

    mentioned that they did not have enough time to inhale, that inspiratory muscles were fatigued , that they got out of rhythm with their breathing and...with APR decreased with time during APR use, a decrease suggesting fatigue of respiratory muscles . Another two subjects did not continue long enough... muscle fatigue , the difference they noted may have been caused by the increase in VE during endurance exercise. The other investigators compared at

  8. 48 CFR 1552.235-76 - Treatment of Confidential Business Information (APR 1996).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Business Information (APR 1996). 1552.235-76 Section 1552.235-76 Federal Acquisition Regulations System... Provisions and Clauses 1552.235-76 Treatment of Confidential Business Information (APR 1996). As prescribed in 1535.007-70(c), insert the following clause: Treatment of Confidential Business Information (TSCA...

  9. Co-treatment with imipramine averted haloperidol-instigated tardive dyskinesia: Association with serotonin in brain regions.

    PubMed

    Samad, Noreen; Yasmin, Farzana; Haleem, Darakhshan Jabeen

    2016-11-01

    Outcome of imipramine (IMI) treatment was scrutinized on progression of haloperidol instigated tardive dyskinesia (TD). 0.2 mg/kg/rat dosage of haloperidol provided orally to rats for 2 weeks enhanced vacuous chewing movements that escalated when the process proceeded for 5 weeks. Following 2 weeks co-injection 5 mg/kg dosage of IMI was diminished haloperidol-instigated VCMs and fully averted following five weeks. The potency of 8-OH-DPAT-instigated locomotor activity exhibited higher in saline+haloperidol treated rats while not observed in IMI+ haloperidol treated rats. 8-OH-DPAT-instigated low 5-hydroxytryptamine (5-HT; serotonin) metabolism was higher in saline+ haloperidol treated rats when compare to IMI+ haloperidol treated rats in both regions of brain (striatum and midbrain). It is recommended that IMI possibly competent in averting TD, in cases receiving treatment to antipsychotics.

  10. Multiplex PCR to detect bacteriophages from natural whey cultures of buffalo milk and characterisation of two phages active against Lactococcus lactis, ΦApr-1 and ΦApr-2.

    PubMed

    Aprea, Giuseppe; Mullan, William Michael; Murru, Nicoletta; Fitzgerald, Gerald; Buonanno, Marialuisa; Cortesi, Maria Luisa; Prencipe, Vincenza Annunziata; Migliorati, Giacomo

    2017-09-30

    This work investigated bacteriophage induced starter failures in artisanal buffalo Mozzarella production plants in Southern Italy. Two hundred and ten samples of whey starter cultures were screened for bacteriophage infection. Multiplex polymerase chain reaction (PCR) revealed phage infection in 28.56% of samples, all showing acidification problems during cheese making. Based on DNA sequences, bacteriophages for Lactococcus lactis (L. lactis), Lactobacillus delbruekii (L. delbruekii) and Streptococcus thermophilus (S. thermophilus) were detected. Two phages active against L. lactis, ΦApr-1 and ΦApr-2, were isolated and characterised. The genomes, approximately 31.4 kb and 31 kb for ΦApr-1 and ΦApr-2 respectively, consisted of double-stranded linear DNA with pac-type system. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS‑PAGE) showed one major structural protein of approximately 32.5 kDa and several minor proteins. This is the first report of phage isolation in buffalo milk and of the use of multiplex PCR to screen and study the diversity of phages against Lactic Acid Bacteria (LAB) strains in artisanal Water Buffalo Mozzarella starters.

  11. 48 CFR 1552.235-75 - Access to Toxic Substances Control Act Confidential Business Information (APR 1996).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Control Act Confidential Business Information (APR 1996). 1552.235-75 Section 1552.235-75 Federal... Confidential Business Information (APR 1996). As prescribed in 1535.007(b), insert the following provision: Access to Toxic Substances Control Act Confidential Business Information (APR 1996) In order to perform...

  12. Successful Treatment of Severe Tardive Dyskinesia with Valbenazine, Including a Patient's Perspective.

    PubMed

    Josiassen, Richard C; Filmyer, Dawn M; Gillean, Jack; Shah, Syed Sikandar; Dietterich, Tyler E; Shaughnessy, Rita A

    2017-11-08

    BACKGROUND Tardive dyskinesia (TD) is a chronic involuntary movement disorder frequently induced by dopamine receptor blockers, particularly first-generation antipsychotics. Until recently, management of TD was restricted to lowering the dose of the current medication, switching to another medication, or using off-label treatments with insufficient evidence of efficacy. Valbenazine, a vesicular monoamine transporter-2 (VMAT2) inhibitor, became the first drug to be approved by the FDA specifically for the treatment of TD. CASE REPORT We describe the case of a 49-year-old African-American woman who was diagnosed with bipolar disorder at the age of 34 and treated with lithium carbonate (900 mg daily) and citalopram (10 mg daily). She also received low doses of second-generation antipsychotics for weeks at a time, but these were always discontinued due to severe sedation. Over a decade later, at the age of 45, she experienced rapid onset of severe TD symptoms. She enrolled in a phase III double-blind clinical trial and received valbenazine 80 mg, with encouraging results. CONCLUSIONS Once-daily dosing of valbenazine (80 mg) was effective and safe over a long period, even in this atypical case of severe and rapid-onset TD.

  13. Development of Nanosatellite Technology with APRS Module for Disaster Mitigation

    NASA Astrophysics Data System (ADS)

    Prahyang, S. Y.; Dhiya’Ulhaq, M. Z.; Golim, O. P.; Gunawan, R.; Suhandinata; Jahja, E.; Nelwan, E. R. G.; Ananta, C.; Chow, I. M.; Mali, N. D. F.

    2018-05-01

    Development of nanosatellite technology has enabled satellites to be developed with multiple capabilities for a specific mission in a short time with a low cost. Satellite communications are proved to be more effective in delivering information due to its large coverage area. Surya Satellite-1 will become the first Indonesian nanosatellite developed by undergraduate students. It is designed with low-cost commercial payloads, including an APRS module for communication and operated on VHF and UHF amateur radio frequencies. The mission of the satellites focused on disaster mitigation through APRS communication network with remote stations located on disaster-prone areas.

  14. Evaluation de la formation des résidents en chirurgie générale et digestive en Tunisie

    PubMed Central

    Mahmoudi, Ammar; Noomen, Faouzi; Nasr, Mohamed; Zouari, Khadija; Hamdi, Abdelaziz

    2015-01-01

    Introduction De nombreux moyens sont mis à disposition des résidents en chirurgie générale et digestive pour assurer leur formation théorique et pratique. Cependant, le niveau d'utilisation de ces différents outils et leur impact sur la formation des résidents n'ont jamais été évalués. L'objectif de notre étude était d’étudier l’état des lieux des moyens de formation utilisés par les résidents pour évaluer leurs degrés de satisfaction et leurs propositions en vue d'améliorer leur formation. Méthodes Un questionnaire anonyme a été distribué aux résidents de chirurgie générale et digestive de l'année 2012-2013. Ce questionnaire portait sur les caractéristiques démographiques, les ressources pédagogiques, ainsi que le cursus médical et universitaire. Une évaluation de la formation ainsi qu'un recueil des propositions faites en vue d'améliorer leurs formations étaient réalisées. Résultats Cinquante résidents sur 83 ont répondu au questionnaire. L'orientation de carrière la plus fréquente était l'hospitalo-universitaire dans 70% des cas. La pratique quotidienne et l'internet étaient les deux ressources pédagogiques les plus utilisées. La formation chirurgicale était jugée satisfaisante par seulement 10% des répondants. Parmi l'ensemble des propositions faites, l'apprentissage sur simulateur chirurgical, l'existence d'un ouvrage national de référence, et l'institution d'un tutorat par un chirurgien senior recueillaient plus de 80% d'avis favorable. Conclusion La majorité des résidents jugent leur formation non satisfaisante. Une meilleure information sur les ressources déjà existantes, un renforcement du compagnonnage et un accès plus large à un apprentissage sur simulateur chirurgical permettraient de diminuer ce sentiment d'insatisfaction. PMID:26587174

  15. Tardive dyskinesia: placing vesicular monoamine transporter type 2 (VMAT2) inhibitors into clinical perspective.

    PubMed

    Citrome, Leslie

    2018-04-01

    Tardive dyskinesia (TD) is an iatrogenic movement disorder caused by exposure to dopamine receptor blocking agents. Two vesicular monoamine transporter type 2 (VMAT2) inhibitors for the treatment of TD were approved by the US Food and Drug Administration in 2017: valbenazine and deutetrabenazine. Areas covered: A brief review of TD and its identification, as well as a review of older treatment interventions is provided, followed by a detailed synthesis regarding the clinical utility of valbenazine and deutetrabenazine. Expert commentary: As evidenced from well-designed clinical trials, both valbenazine and deutetrabenazine are efficacious and tolerable. They differ in terms of labeled instructions for frequency of administration (twice daily for deutetrabenazine vs. once daily for valbenazine), titration requirements (dose to efficacy/tolerability for deutetrabenazine vs. titrate to target dose of 80 mg/day for valbenazine), need for food (administer deutetrabenazine with food), drug-drug interactions (consider CYP2D6 modulators for deutetrabenazine vs. both CYP2D6 and CYP3A4 for valbenazine), contraindications (hepatic impairment for deutetrabenazine), and minor differences in adverse event profile.

  16. Miscellaneous treatments for antipsychotic-induced tardive dyskinesia.

    PubMed

    Soares-Weiser, Karla; Rathbone, John; Ogawa, Yusuke; Shinohara, Kiyomi; Bergman, Hanna

    2018-03-19

    Antipsychotic (neuroleptic) medication is used extensively to treat people with chronic mental illnesses. Its use, however, is associated with adverse effects, including movement disorders such as tardive dyskinesia (TD) - a problem often seen as repetitive involuntary movements around the mouth and face. This review, one in a series examining the treatment of TD, covers miscellaneous treatments not covered elsewhere. To determine whether drugs, hormone-, dietary-, or herb-supplements not covered in other Cochrane reviews on TD treatments, surgical interventions, electroconvulsive therapy, and mind-body therapies were effective and safe for people with antipsychotic-induced TD. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials including trial registers (16 July 2015 and 26 April 2017), inspected references of all identified studies for further trials and contacted authors of trials for additional information. We included reports if they were randomised controlled trials (RCTs) dealing with people with antipsychotic-induced TD and schizophrenia or other chronic mental illnesses who remained on their antipsychotic medication and had been randomly allocated to the interventions listed above versus placebo, no intervention, or any other intervention. We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CIs). We assumed that people who left early had no improvement. We assessed risk of bias and created 'Summary of findings' tables using GRADE. We included 31 RCTs of 24 interventions with 1278 participants; 22 of these trials were newly included in this 2017 update. Five trials are awaiting classification and seven trials are ongoing. All participants were adults with chronic psychiatric disorders, mostly schizophrenia, and antipsychotic-induced TD. Studies were primarily of short (three to six6 weeks) duration with small samples size (10 to 157

  17. APR-246/PRIMA-1Met Inhibits and Reverses Squamous Metaplasia in Human Conjunctival Epithelium.

    PubMed

    Li, Jing; Li, Cheng; Wang, Guoliang; Liu, Zhen; Chen, Pei; Yang, Qichen; Dong, Nuo; Wu, Huping; Liu, Zuguo; Li, Wei

    2016-02-01

    Squamous metaplasia is a common pathologic condition in ocular surface diseases for which there is no therapeutic medication in clinic. In this study, we investigated the effect of a small molecule, APR-246/PRIMA-1(Met), on squamous metaplasia in human conjunctival epithelium. Human conjunctival explants were cultured for up to 12 days under airlifting conditions. Epithelial cell differentiation and proliferation were assessed by Cytokeratin 10 (K10), K14, K19, Pax6, MUC5AC, and p63 immunostaining patterns. β-catenin and TCF-4 immunofluorescent staining and real-time PCR characterized Wnt signaling pathway involvement. Pterygium clinical samples were cultured under airlifting conditions with or without APR-246 for 4 days. p63, K10, β-catenin, and TCF-4 expression in pterygial epithelium was determined by immunofluorescent staining and real-time PCR. Airlift conjunctival explants resulted in increased stratification and intrastromal epithelial invagination. Such pathology was accompanied by increases in K10, K14, and p63 expression, whereas K19 and Pax6 levels declined when compared to those in freshly isolated tissue. On the other hand, APR-246 reversed all of these declines in K10, K14, and p63 expression. Furthermore, K19 and Pax6 increased along with rises in goblet cell density. These effects of APR-246 were accompanied by near restoration of normal conjunctival epithelial histology. APR-246 also reversed squamous metaplasia in pterygial epithelium that had developed after 4 days in ex vivo culture. Reductions in squamous metaplasia induced by APR-246 suggest it may provide a novel therapeutic approach in different squamous metaplasia-associated ocular surface diseases.

  18. The Ongoing Rediscovery of Après-Coup as a Central Freudian Concept.

    PubMed

    House, Jonathan

    2017-10-01

    Après-coup, Freud's Nachträglichkeit, is an essential psychoanalytic concept structuring each of four concepts, four mental processes that lie at the foundation of Freud's thinking: psychic trauma, repression, the creation of the unconscious, and the creation of infantile sexuality. It is argued here that infantile sexual drives, in contrast to the self-preservative instincts, arise from a two-step process of translation and repression in which the residues of failed translation become source-objects of the drives. These residues of failed translation have an associative resonance with adult sexuality, and the child is driven to ongoing attempts to translate them, to make them meaningful après coup. Thus, après-coup is at the heart of the human subject as a sexual creature who requires, desires, and creates meaning.

  19. The effect of chronic administration of sarizotan, 5-HT1A agonist/D3/D4 ligand, on haloperidol-induced repetitive jaw movements in rat model of tardive dyskinesia.

    PubMed

    Rosengarten, Helen; Bartoszyk, Gerd D; Quartermain, David; Lin, Yan

    2006-03-01

    Dyskinesia is the most troublesome side effect in long-term treatment of both Parkinson's disease (PD) and schizophrenia. The 5-HT1A agonist and D3/D4 ligand sarizotan [Bartoszyk, G.D., van Amsterdam, C., Greiner, H.E., Rautenberg, W., Russ, H., Seyfried, C.A., 2004. Sarizotan, a serotonin 5-HT1A receptor agonist and dopamine receptor ligand. 1. Neurochemical profile. J. Neural Transm. 111, 113-126.] is in clinical development for the treatment of PD-associated dyskinesia. Because 5-HT1A agonists are known to counteract antipsychotic-induced motor side effects, sarizotan was investigated for its effects in two rat models of tardive dyskinesia (TD). The acute administration of sarizotan (0.17-13.5 mg/kg i.p.) reduced episodes of SKF 38393-induced repetitive jaw movements (RJM) in rats with a maximal effect at 1.5 mg/kg. In a chronic study, sarizotan (0.04-9 mg/kg/day), administered in the drinking water for 7 weeks during withdrawal from chronic haloperidol treatment (1.5 mg/kg/day), dose-dependently reversed haloperidol-induced RJM, significant at the doses of 1.5 and 9 mg/kg. Agonism at 5-HT1A receptors may be mediating the inhibitory effect of sarizotan on RJM in rat models of tardive dyskinesia.

  20. Histopathologic findings in Unna's nevus suggest it is a tardive congenital nevus.

    PubMed

    Sowa, Junko; Kobayashi, Hiromi; Ishii, Masamitsu; Kimura, Tetsunori

    2008-12-01

    According to A. Bernard Ackerman's clinical histopathologic classification of nevi, the essential histopathologic finding of an Unna's nevus is localization of melanocytic nevus cells to a markedly thickened papillary dermis of an exophytic lesion. In this study, we examined 94 completely resected Unna's nevi in which several sections of the same lesion could be examined. We examined that melanocytic nevus cells were not just localized to the exophytic portion but were also commonly distributed below it (81 lesions, 86.2%). Melanocytic nevus cells were found in a periadnexal distribution in most of the lesions in which they extended below the exophytic part and were most frequently noted around hair follicles (60 lesions, 63.8%), then around eccrine ducts (43 lesions, 45.7%), and least frequently around sebaceous glands or ducts (36 lesions, 38.3%). Nests of melanocytic nevus cells were present in follicular epithelium in 7 lesions, sebaceous ducts in 1 lesion, and eccrine ducts in 1 lesion. Moreover, type A nevus cells containing melanin granules were observed in 16 lesions (17.0%) when they were distributed around hair follicles, in 8 lesions (8.5%) when distributed around sebaceous glands or ducts, and in 1 lesion (1.1%) when distributed around eccrine ducts. Although Unna's nevus is clinically an acquired nevus, it has many histopathologic characteristics of a congenital melanocytic nevus and is therefore likely a tardive congenital lesion.

  1. Prevalence and risk factors associated with tardive dyskinesia among Indian patients with schizophrenia.

    PubMed

    Achalia, Rashmin M; Chaturvedi, Santosh K; Desai, Geetha; Rao, Girish N; Prakash, Om

    2014-06-01

    Tardive dyskinesia (TD) is one of the most distressing side effects of antipsychotic treatment. As prevalence studies of TD in Asian population are scarce, a cross-sectional study was performed to assess the frequency of TD in Indian patients with schizophrenia and risk factors of TD. Cross-sectional study of 160 Indian patients fulfilling the DSM-IV TR criteria for schizophrenia and who received antipsychotics for at least one year, were examined with two validated scales for TD. Logistic regression analyses were used to examine the relationship between TD and clinical risk factors. The frequency of probable TD in the total sample was 26.4%. The logistic regression yielded significant odds ratios between TD and age, intermittent treatment, and total cumulative antipsychotic dose. The difference of TD between SGA and FGA disappeared after adjusting for important co-variables in regression analysis. Indian patients with schizophrenia and long-term antipsychotic treatment have a high risk of TD, and TD is associated with older age, intermittent antipsychotic treatment, and a high total cumulative antipsychotic dose. Our study findings suggest that there is no significant difference between SGAs with regards to the risk of causing TD as compared to FGAs. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Analyse Pharmaceutique de la prescription des antibiotiques au service des brules et chirurgie plastique de l'Hopital Militaire d'Instruction Mohammed V, Maroc

    PubMed Central

    Benziane, H.; Karfo, R.; Siah, S.; Taoufik, J.

    2011-01-01

    Summary L'infection est longtemps restée la principale cause de mortalité chez le brûlé grave. Ce travail a pour but d'évaluer la prescription des antibiotiques dans notre Service des Brûlés et Chirurgie Plastique, au regard du dossier d'autorisation de mise sur le marché (Résumé des caractéristiques du produit). Tous les patients sous antibiothérapie, au Service des Brûlés et Chirurgie Plastique de l'Hôpital Militaire d'Instruction Mohammed V de Rabat, Maroc, durant la période janvier 2008/mai 2009, ont été inclus. Il s'agit d'une étude rétrospective qui a analysé 41 dossiers de patients. Les antibiotiques utilisés par le service appartiennent à différentes familles. Les plus utilisés sont les bêta-lactamines (65%), glycopeptides (10,5%), aminosides (9%), quinolones (7%) et colistine (4,3%), avec 4,2% pour les autres classes d'antibiotiques (métronidazole 500 mg en perfusion, fluconazole injectable 100 mg/50 ml, rifampicine 600 mg en perfusion, sulfadiazine argentique crème, acide fusidique 2% crème, etc.); 70% des prescriptions sont non documentées. La voie injectable est prépondérante (89%). En tout, 227 ordonnances nominatives d'antibiothérapie ont été analysées: la posologie et les contre-indications ont été respectées par rapport à l'autorisation de mise sur le marché. Trois cas d'interactions médicamenteuses ont été relevés (fluconazole-rifampicine, fluconazole-Saccharomyces boulardii, amikacine-vancomycine). Ce constat montre l'importance de l'analyse pharmaceutique des prescriptions des antibiotiques dans un service utilisant des antibiotiques de la réserve hospitalière, donc actifs mais très toxiques. PMID:22396670

  3. 12. Historic American Buildings Survey Arthur C. Haskell, Photographer Apr. ...

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

    12. Historic American Buildings Survey Arthur C. Haskell, Photographer Apr. 1, 1939 (l) INT.- STAIRWAY, 4th FLOOR, LOOKING SOUTH - M.I.T., Rogers Building, 491 Boylston Street, Boston, Suffolk County, MA

  4. 9. Historic American Buildings Survey Arthur C. Haskell, Photographer Apr. ...

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

    9. Historic American Buildings Survey Arthur C. Haskell, Photographer Apr. 1, 1939 (i) INT.- STAIR HALL, 1st. FLOOR, LOOKING NORTH - M.I.T., Rogers Building, 491 Boylston Street, Boston, Suffolk County, MA

  5. 14 CFR Appendix H to Part 23 - Installation of An Automatic Power Reserve (APR) System

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Installation of An Automatic Power Reserve (APR) System H Appendix H to Part 23 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... AIRPLANES Pt. 23, App. H Appendix H to Part 23—Installation of An Automatic Power Reserve (APR) System H23.1...

  6. Vitamin E for neuroleptic-induced tardive dyskinesia.

    PubMed

    Soares-Weiser, Karla; Maayan, Nicola; McGrath, John

    2011-02-16

    Antipsychotic (neuroleptic) medication is used extensively to treat people with chronic mental illnesses. Its use, however, is associated with adverse effects, including movement disorders such as tardive dyskinesia (TD) - a problem often seen as repetitive involuntary movements around the mouth and face. Vitamin E has been proposed as a treatment to prevent or decrease TD. To determine the effects of vitamin E for people with schizophrenia or other chronic mental illnesses who also developed neuroleptic-induced TD. We searched the Cochrane Schizophrenia Group Trials Register (March 2010), inspected references of all identified studies for further trials and contacted authors of trials for additional information. We included reports if they were controlled trials dealing with people with neuroleptic-induced TD and schizophrenia who had been randomly allocated to either vitamin E or to a placebo or no intervention. We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who dropped out had no improvement. The review now includes 11 poorly reported randomised trials (total 427 people). There was no clear difference between vitamin E and placebo for the outcome of 'clinically relevant improvement in TD' (6 trials, 256 people, RR 0.95 CI 0.89 to 1.02). For the outcome of 'any improvement in TD symptoms', again, we found no clear difference between groups (7 trials, 311 people, RR 0.86 CI 0.75 to 1.00). However, people allocated to placebo showed more deterioration of their symptoms compared with those given vitamin E (5 trials, 98 people, RR 0.38 CI 0.16 to 0.9). There was no difference in the incidence of adverse effects (9 trials, 203 people, RR 1.29 CI 0.51 to 3.24) or leaving the study early (medium term 6 trials, 173 people, RR 1.29 CI 0.72 to 2.3). There is no trial-based information regarding the effect of vitamin E for those with early onset of TD

  7. Human factors engineering verification and validation for APR1400 computerized control room

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

    Shin, Y. C.; Moon, H. K.; Kim, J. H.

    2006-07-01

    This paper introduces the Advanced Power Reactor 1400 (APR1400) HFE V and V activities the Korea Hydro Nuclear Plant Co. LTD. (KHNP) has performed for the last 10 years and some of the lessons learned through these activities. The features of APR1400 main control room include large display panel, redundant compact workstations, computer-based procedure, and safety console. Several iterations of human factors evaluations have been performed from small scale proof of concept tests to large scale integrated system tests for identifying human engineering deficiencies in the human system interface design. Evaluations in the proof of concept test were focused onmore » checking the presence of any show stopper problems in the design concept. Later evaluations were mostly for finding design problems and for assuring the resolution of human factors issues of advanced control room. The results of design evaluations were useful not only for refining the control room design, but also for licensing the standard design. Several versions of APR1400 mock-ups with dynamic simulation models of currently operating Korea Standard Nuclear Plant (KSNP) have been used for the evaluations with the participation of operators from KSNP plants. (authors)« less

  8. [Evaluation of the capacity of the APR-DRG classification system to predict hospital mortality].

    PubMed

    De Marco, Maria Francesca; Lorenzoni, Luca; Addari, Piero; Nante, Nicola

    2002-01-01

    Inpatient mortality has increasingly been used as an hospital outcome measure. Comparing mortality rates across hospitals requires adjustment for patient risks before making inferences about quality of care based on patient outcomes. Therefore it is essential to dispose of well performing severity measures. The aim of this study is to evaluate the ability of the All Patient Refined DRG system to predict inpatient mortality for congestive heart failure, myocardial infarction, pneumonia and ischemic stroke. Administrative records were used in this analysis. We used two statistics methods to assess the ability of the APR-DRG to predict mortality: the area under the receiver operating characteristics curve (referred to as the c-statistic) and the Hosmer-Lemeshow test. The database for the study included 19,212 discharges for stroke, pneumonia, myocardial infarction and congestive heart failure from fifteen hospital participating in the Italian APR-DRG Project. A multivariate analysis was performed to predict mortality for each condition in study using age, sex and APR-DRG risk mortality subclass as independent variables. Inpatient mortality rate ranges from 9.7% (pneumonia) to 16.7% (stroke). Model discrimination, calculated using the c-statistic, was 0.91 for myocardial infarction, 0.68 for stroke, 0.78 for pneumonia and 0.71 for congestive heart failure. The model calibration assessed using the Hosmer-Leme-show test was quite good. The performance of the APR-DRG scheme when used on Italian hospital activity records is similar to that reported in literature and it seems to improve by adding age and sex to the model. The APR-DRG system does not completely capture the effects of these variables. In some cases, the better performance might be due to the inclusion of specific complications in the risk-of-mortality subclass assignment.

  9. Review of APR+ Level 2 PSA. Revision 2

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

    Lehner, John R.; Mubayi, Vinod; Pratt, W. Trevor

    2012-02-17

    Brookhaven National Laboratory (BNL) assisted the Korea Institute of Nuclear Safety (KINS) in reviewing the Level 2 Probabilistic Safety Assessment (PSA) of the APR+ Advanced Pressurized Water Reactor (PWR) prepared by the Korea Hydro & Nuclear Power Co., Ltd (KHNP) and KEPCO Engineering & Construction Co., Inc. (KEPCO-E&C). The work described in this report involves a review of the APR+ Level 2 PSA submittal [Ref. 1]. The PSA and, therefore, the review is limited to consideration of accidents initiated by internal events. As part of the review process, the review team also developed three sets of Requests for Additional Informationmore » (RAIs). These RAIs were provided to KHNP and KEPCO-E&C for their evaluation and response. This final detailed report documents the review findings for each technical element of the PSA and includes consideration of all of the RAIs made by the reviewers as well as the associated responses. This final report was preceded by an interim report [Ref. 2] that focused on identifying important issues regarding the PSA. In addition, a final meeting on the project was held at BNL on November 21-22, 2011, where BNL and KINS reviewers discussed their preliminary review findings with KHNP and KEPCO-E&C staffs. Additional information obtained during this final meeting was also used to inform the review findings of this final report. The review focused not only on the robustness of the APR+ design to withstand severe accidents, but also on the capability and acceptability of the Level 2 PSA in terms of level of detail and completeness. The Korean nuclear regulatory authorities will decide whether the PSA is acceptable and the BNL review team is providing its comments for KINS consideration. Section 2.0 provides the basis for the BNL review. Section 3.0 presents the review of each technical element of the PSA. Conclusions and a summary are presented in Section 4.0. Section 5.0 contains the references.« less

  10. 81. Neg. No. F63, Apr 13, 1930, INTERIORASSEMBLY BUILDING, HOOD ...

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

    81. Neg. No. F-63, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, HOOD DEPARTMENT - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  11. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods.

    PubMed

    Kaplan, Bonnie J; Giesbrecht, Gerald F; Leung, Brenda M Y; Field, Catherine J; Dewey, Deborah; Bell, Rhonda C; Manca, Donna P; O'Beirne, Maeve; Johnston, David W; Pop, Victor J; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P; Eliasziw, Misha; McCargar, Linda J; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M; Letourneau, Nicole; Martin, Jonathan W

    2014-01-01

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners). The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age. The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration. © 2012 John Wiley & Sons Ltd.

  12. 83. Neg. No. F53, Apr 13, 1930, INTERIORASSEMBLY BUILDING, BACK ...

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

    83. Neg. No. F-53, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, BACK TRIM LINE - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  13. 86. Neg. No. F64, Apr 13, 1930, INTERIORASSEMBLY BUILDING, BODY ...

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

    86. Neg. No. F-64, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, BODY STORAGE CONVEYOR - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  14. 15 CFR 782.1 - Overview of reporting requirements under the APR.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL... (see § 782.5 of the APR). In addition, forms may be downloaded from the Internet at http://www.ap.gov. ...

  15. 15 CFR 782.1 - Overview of reporting requirements under the APR.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL... (see § 782.5 of the APR). In addition, forms may be downloaded from the Internet at http://www.ap.gov. ...

  16. 15 CFR 782.1 - Overview of reporting requirements under the APR.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL... (see § 782.5 of the APR). In addition, forms may be downloaded from the Internet at http://www.ap.gov. ...

  17. 15 CFR 782.1 - Overview of reporting requirements under the APR.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL... (see § 782.5 of the APR). In addition, forms may be downloaded from the Internet at http://www.ap.gov. ...

  18. 85. Neg. No. F51, Apr 13, 1930, INTERIORASSEMBLY BUILDING, BODY ...

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

    85. Neg. No. F-51, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, BODY AND CUSHION LINE - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  19. Assistant Personal Robot (APR): Conception and Application of a Tele-Operated Assisted Living Robot.

    PubMed

    Clotet, Eduard; Martínez, Dani; Moreno, Javier; Tresanchez, Marcel; Palacín, Jordi

    2016-04-28

    This paper presents the technical description, mechanical design, electronic components, software implementation and possible applications of a tele-operated mobile robot designed as an assisted living tool. This robotic concept has been named Assistant Personal Robot (or APR for short) and has been designed as a remotely telecontrolled robotic platform built to provide social and assistive services to elderly people and those with impaired mobility. The APR features a fast high-mobility motion system adapted for tele-operation in plain indoor areas, which incorporates a high-priority collision avoidance procedure. This paper presents the mechanical architecture, electrical fundaments and software implementation required in order to develop the main functionalities of an assistive robot. The APR uses a tablet in order to implement the basic peer-to-peer videoconference and tele-operation control combined with a tactile graphic user interface. The paper also presents the development of some applications proposed in the framework of an assisted living robot.

  20. Tardive dyskinesia in schizophrenia is associated with prolactin-related sexual disturbances.

    PubMed

    Tenback, Diederik E; van Harten, Peter N; Slooff, Cees J; van Os, Jim

    2006-08-01

    Tardive dyskinesia (TD) may occur in never-medicated patients with psychotic illness, indicating the existence of non-medication, possibly disease-related, causes. We tested the hypothesis that, independent of the antipsychotic-induced rise in prolactin, the incidence of TD would be associated with the incidence of prolactin-related sexual disturbances (PRSD), which would be suggestive of a common pathology involving multiple dopamine tracts. Simple, global measures of TD and PRSD (loss of libido, amenorrhea, gynaecomastia, impotence, and galactorrhea) were rated in a prospective, observational European Health Outcomes Study (SOHO). New onset of TD and new onset of PRSD at 3, 6, and 12 months was analyzed in a risk set of 4263 patients using a Cox proportional hazard model yielding adjusted hazard ratios (aHR). Incidence of TD was significantly and linearly comorbid with the incidence of PRSD in both men and women. Compared to those with no PRSD, the risk for TD was 2.0 (95% CI: 1.1, 3.7) with one PRSD, 2.4 (95% CI: 1.3, 4.5) with two PRSD, and 3.6 (95% CI: 1.1, 11.8) with three PRSD. Associations were stronger in those who only had received prolactin-sparing medications (aHR per unit PRSD increase=2.0, 95% CI: 1.2, 3.3) than in those who only had received prolactin-raising medications (aHR=1.3, 95% CI: 0.9, 1.9). In people with schizophrenia, TD and PRSD show comorbidities that are independent of antipsychotic-induced alterations in plasma prolactin. This may suggest a shared, pandopaminergic pathological mechanism associated with schizophrenia itself, rather than only a medication effect.

  1. 84. Neg. No. F62, Apr 13, 1930, INTERIORASSEMBLY BUILDING, FRAME ...

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

    84. Neg. No. F-62, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, FRAME AND MOTOR STORAGE CONVEYOR - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  2. 76. Neg. No. F58, Apr 13, 1930, INTERIORASSEMBLY BUILDING, BURNOFF, ...

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

    76. Neg. No. F-58, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, BURNOFF, LOAD END OF ENAMEL OVEN - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  3. New tools for NTD vaccines: A case study of quality control assays for product development of the human hookworm vaccine Na-APR-1M74.

    PubMed

    Pearson, Mark S; Jariwala, Amar R; Abbenante, Giovanni; Plieskatt, Jordan; Wilson, David; Bottazzi, Maria Elena; Hotez, Peter J; Keegan, Brian; Bethony, Jeffrey M; Loukas, Alex

    2015-01-01

    Na-APR-1(M74) is an aspartic protease that is rendered enzymatically inactive by site-directed mutagenesis and is a candidate antigen component in the Human Hookworm Vaccine. The mutant protease exerts vaccine efficacy by inducing antibodies that neutralize the enzymatic activity of wild type enzyme (Na-APR-1wt) in the gut of the hookworm, thereby depriving the worm of its ability to digest its blood meal. Previously, canines immunized with Na-APR-1(M74) and challenged with Ancylostoma caninum were partially protected against hookworm challenge infection, especially from the loss in hemoglobin observed in control canines and canine immunoglobulin (Ig) G raised against Na-APR-1 was shown to inhibit the enzymatic activity of Na-APR-1 wt in vitro, thereby providing proof of concept of Na-APR-1(M74) as a vaccine antigen. The mutated version, Na-APR-1(M74), was then expressed at the cGMP level using a Nicotiana benthamiana expression system (Fraunhofer, CMB, Delaware, MD), formulated with Alhydrogel®, and used to immunize mice in a dose-ranging study to explore the enzyme-neutralizing capacity of the resulting anti- Na-APR-1(M74) IgG. As little as 0.99 μg of recombinant Na-APR-1(M74) could induce anti Na-APR-1(M74) IgG in mice that were capable of inhibiting Na-APR-1w t-mediated digestion of a peptide substrate by 89%. In the absence of enzymatic activity of Na-APR-1(M74) as a surrogate marker of protein functionality, we developed an assay based on the binding of a quenched fluorescence-labeled inhibitor of aspartic proteases, BODIPY-FL pepstatin A (BDP). Binding of BDP in the active site of Na-APR-1 wt was demonstrated by inhibition of enzymatic activity, and competitive binding with unlabelled pepstatin A. BDP also bound to Na-APR-1(M74) which was assessed by fluorescence polarization, but with an ∼ 50-fold reduction in the dissociation constant. Taken together, these assays comprise a "toolbox" that could be useful for the analyses of Na-APR-1(M74) as it

  4. New tools for NTD vaccines: A case study of quality control assays for product development of the human hookworm vaccine Na-APR-1M74

    PubMed Central

    Pearson, Mark S; Jariwala, Amar R; Abbenante, Giovanni; Plieskatt, Jordan; Wilson, David; Bottazzi, Maria Elena; Hotez, Peter J; Keegan, Brian; Bethony, Jeffrey M; Loukas, Alex

    2015-01-01

    Na-APR-1M74 is an aspartic protease that is rendered enzymatically inactive by site-directed mutagenesis and is a candidate antigen component in the Human Hookworm Vaccine. The mutant protease exerts vaccine efficacy by inducing antibodies that neutralize the enzymatic activity of wild type enzyme (Na-APR-1wt) in the gut of the hookworm, thereby depriving the worm of its ability to digest its blood meal. Previously, canines immunized with Na-APR-1M74 and challenged with Ancylostoma caninum were partially protected against hookworm challenge infection, especially from the loss in hemoglobin observed in control canines and canine immunoglobulin (Ig) G raised against Na-APR-1 was shown to inhibit the enzymatic activity of Na-APR-1wt in vitro, thereby providing proof of concept of Na-APR-1M74 as a vaccine antigen. The mutated version, Na-APR-1M74, was then expressed at the cGMP level using a Nicotiana benthamiana expression system (Fraunhofer, CMB, Delaware, MD), formulated with Alhydrogel®, and used to immunize mice in a dose-ranging study to explore the enzyme-neutralizing capacity of the resulting anti- Na-APR-1M74 IgG. As little as 0.99 μg of recombinant Na-APR-1M74 could induce anti Na-APR-1M74 IgG in mice that were capable of inhibiting Na-APR-1wt-mediated digestion of a peptide substrate by 89%. In the absence of enzymatic activity of Na-APR-1M74 as a surrogate marker of protein functionality, we developed an assay based on the binding of a quenched fluorescence-labeled inhibitor of aspartic proteases, BODIPY-FL pepstatin A (BDP). Binding of BDP in the active site of Na-APR-1wt was demonstrated by inhibition of enzymatic activity, and competitive binding with unlabelled pepstatin A. BDP also bound to Na-APR-1M74 which was assessed by fluorescence polarization, but with an ∼50-fold reduction in the dissociation constant. Taken together, these assays comprise a “toolbox” that could be useful for the analyses of Na-APR-1M74 as it proceeds through the

  5. 15 CFR 782.5 - Where to obtain APR report forms.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

  6. 15 CFR 782.5 - Where to obtain APR report forms.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

  7. 15 CFR 782.5 - Where to obtain APR report forms.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

  8. 15 CFR 782.5 - Where to obtain APR report forms.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

  9. 15 CFR 782.5 - Where to obtain APR report forms.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

  10. Forgotten but not gone: new developments in the understanding and treatment of tardive dyskinesia.

    PubMed

    Meyer, Jonathan M

    2016-12-01

    The broad use of atypical antipsychotics was expected to dramatically reduce the prevalence and incidence of tardive dyskinesia (TD), but data show that TD remains an important challenge due the persistent nature of its symptoms and resistance to numerous treatment modalities, including antipsychotic discontinuation. Recent insights on genetic risk factors and new concepts surrounding pathophysiology have spurred interest in the possibility of targeted treatment for TD. As will be reviewed in this article, the number of evidence-based strategies for TD treatment is small: only clonazepam, amantadine, ginkgo biloba extract, and the vesicular monoamine transporter 2 (VMAT2) inhibitor tetrabenazine have compelling data. Using new insights into the metabolism of tetrabenazine and the properties of its active metabolites, 2 modifications of tetrabenazine have been synthesized to improve the kinetic profile, and are currently involved in double-blind placebo controlled studies aimed at U.S. Food and Drug Administration (FDA) regulatory approval. The possible availability of these new agents, deuterated tetrabenazine and valbenazine, significantly widens the range of treatment choices for patients with TD. For clinicians with patients at risk for TD due to dopamine antagonist exposure, experience has shown that the problem of TD will be an ongoing issue in modern psychiatry, and that an appreciation of new developments in the pathophysiology of, risk factors for, and treatment of TD is crucial to managing this condition.

  11. Après-Coup in French Psychoanalysis: The Long Afterlife of Nachträglichkeit: The First Hundred Years, 1893 to 1993.

    PubMed

    House, Jonathan; Slotnick, Julie

    2015-10-01

    Après-coup finds its origins in Freud's earliest psychoanalytic writings, but it was only half a century ago that French psychoanalysts rediscovered, clarified, and developed the concept and so brought it recognition as an essential Freudian concept. Because the history of après-coup is embedded in the French reading of Freud, this article will give an account of that reading in relation to après-coup.

  12. 79. Neg. No. F61A, Apr 13, 1930, INTERIORASSEMBLY BUILDING, BODY ...

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

    79. Neg. No. F-61A, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, BODY CONSTRUCTION - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  13. Ostéogenèse imparfaite type III de découverte tardive: à propos d'un cas

    PubMed Central

    Rachidi, Wafae; Nassar, Kawtar; Janani, Saadia; Mkinsi, Ouafa

    2015-01-01

    Patient âgé de 52 ans, était admis dans notre établissement pour des polyarthralgies chroniques, plutôt mécaniques, touchant spécialement les articulations du membre inférieur. L'interrogatoire retrouvait l'antécédent de fractures répétées depuis l'enfance, pour des traumatismes minimes, suite à des chutes par glissement. Les signes cliniques et radiologiques, notamment, les fractures récurrentes, sclérotiques bleues, hyperlaxité ligamentaire, dentinogenèse imparfaite, syndrome dysmorphique, ostéoporose densitométrique importante, plaidaient tous en faveur d'une ostéogénèse imparfaite type III. Le patient a initié le traitement, par prise régulière du calcium (1g/jour), supplémentation en vitamine D, et il est programmé pour perfusion de Bisphosphonate (Pamidronate 60mg). Ce cas illustre une forme rare de découverte tardive d'ostéogénèse imparfaite type III. PMID:25995811

  14. 77. Neg. No. F65A, Apr 13, 1930, INTERIORASSEMBLY BUILDING, UNLOADING ...

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

    77. Neg. No. F-65A, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, UNLOADING THE ENAMEL OVEN - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  15. 90. Neg. No. F59A, Apr 13, 1930, INTERIORASSEMBLY BUILDING, CHASSIS ...

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

    90. Neg. No. F-59A, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, CHASSIS LINE, LOOKING SOUTH - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  16. 82. Neg. No. F66A, Apr 13, 1930, INTERIORASSEMBLY BUILDING, TRIM ...

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

    82. Neg. No. F-66A, Apr 13, 1930, INTERIOR-ASSEMBLY BUILDING, TRIM LINE AND GLASS DEPARTMENTS - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  17. 78. Neg. No. F143A, Apr 1, 1932, INTERIORASSEMBLY BUILDING, CONVEYOR ...

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

    78. Neg. No. F-143A, Apr 1, 1932, INTERIOR-ASSEMBLY BUILDING, CONVEYOR LINE WITH CAR CHASSIS - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  18. 15 CFR 782.1 - Overview of reporting requirements under the APR.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Overview of reporting requirements under the APR. 782.1 Section 782.1 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL...

  19. Résultats de la chirurgie laparoscopique pour la hernie de l’aine: l’expérience Tunisienne

    PubMed Central

    Maghrebi, Houcine; Makni, Amin; Sebai, Amin; Chebbi, Faouzi; Rebai, Wael; Daghfous, Amin; Ksantini, Rachid; Jouini, Mohamed; Kacem, Montassar; Safta, Zoubeir Ben

    2018-01-01

    La hernie de l'aine de l'adulte reste une affection fréquente en chirurgie digestive. De nombreuses techniques de réparation ont été décrites à ce jour dont les procédés laparoscopiques. Deux méthodes furent rapidement adoptées par les différents praticiens pour le traitement chirurgical des hernies de l'aine par laparoscopie: la méthode laparoscopique totalement extra péritonéale (TEP) et la méthode laparoscopique transpéritonéale (TAPP). Le but était d'étudier la faisabilité de la cure de hernie de l'aine par cœlioscopie et de décrire ses résultats du point de vue récidive herniaire et douleur post opératoire. Ce travail était une étude rétrospective, uni centrique, et transversale, portant sur des patients opérés par des chirurgiens du service de chirurgie A La Rabta pour hernie de l'aine par voie laparoscopique, sur une période de 8 ans allant de janvier 2006 à décembre 2013. Le principal critère de jugement était la récidive herniaire. La douleur post opératoire et les complications étaient les critères de jugement secondaires. Nous avons colligés 104 hernies chez 92 patients respectant les critères d'inclusion de notre étude. La moyenne d'âge de nos patients était de 48 Ans (19-83). L'approche TAPP était la plus utilisée: 94 cas (90%) TAPP contre 10 cas TEP. Aucune complication per opératoires n'a été signalée. Le taux de conversion de notre série était nul. La mortalité opératoire était aussi nulle. La morbidité postopératoire était de 5% (5 patients). Elle était à type d'hématome dans 3 cas et de sérum dans 2 cas. La durée moyenne d'hospitalisation était de 1.2 jours (1-4jours). Le séjour post opératoire n'avait pas dépassé 2 jours chez 94% des patients. Seulement 2 patients avaient présenté une récidive. Les douleurs chroniques postopératoires étaient notées chez seulement 3 patients. Notre étude a montré que la cure de hernie de l'aine par laparoscopie a apporté un confort consid

  20. Main steam line break accident simulation of APR1400 using the model of ATLAS facility

    NASA Astrophysics Data System (ADS)

    Ekariansyah, A. S.; Deswandri; Sunaryo, Geni R.

    2018-02-01

    A main steam line break simulation for APR1400 as an advanced design of PWR has been performed using the RELAP5 code. The simulation was conducted in a model of thermal-hydraulic test facility called as ATLAS, which represents a scaled down facility of the APR1400 design. The main steam line break event is described in a open-access safety report document, in which initial conditions and assumptionsfor the analysis were utilized in performing the simulation and analysis of the selected parameter. The objective of this work was to conduct a benchmark activities by comparing the simulation results of the CESEC-III code as a conservative approach code with the results of RELAP5 as a best-estimate code. Based on the simulation results, a general similarity in the behavior of selected parameters was observed between the two codes. However the degree of accuracy still needs further research an analysis by comparing with the other best-estimate code. Uncertainties arising from the ATLAS model should be minimized by taking into account much more specific data in developing the APR1400 model.

  1. 91. Neg. No. F174A, Apr 24, 1936, INTERIORASSEMBLY BUILDING, FINISHED ...

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

    91. Neg. No. F-174A, Apr 24, 1936, INTERIOR-ASSEMBLY BUILDING, FINISHED CARS AT THE END OF THE ASSEMBLY LINE - Ford Motor Company Long Beach Assembly Plant, Assembly Building, 700 Henry Ford Avenue, Long Beach, Los Angeles County, CA

  2. Antioxidant effects of rice bran oil mitigate repeated haloperidol-induced tardive dyskinesia in male rats.

    PubMed

    Samad, Noreen; Haleem, Darakhshan Jabeen

    2017-08-01

    Tardive dyskinesia (TD) is associated with the use of antipsychotic drugs such as D2 antagonist haloperidol (HP). The chronic use of HP is involved in the causation of free radicals and/or oxidative stress. In view of the nootropic, anti-anxiety, anti-inflammatory-like effects of rice bran oil (RBO) in a variety of investigations, we assessed the protective properties of RBO on HP-induced TD and neurochemical alteration. Rats treated with HP orally at a dose of 0.2 mg/kg/day for a period of 5 weeks developed VCMs which increased progressively as the treatment continued for 5 weeks. Co-administration of RBO by oral tubes at a dose of 0.4 ml/day prevented the induction of HP-induced VCMs. Repeated administration of HP increases the turnover of dopamine metabolism in the striatum. Conversely animals treated with HP + RBO decrease the metabolism of DA than water + HP treated animals. Striatal, malondieldehyde (MDA), hydrogen peroxide (H 2 O 2 ) and antioxidant enzyme superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were also determined. It is suggested that beneficial role of RBO in attenuation of HP-induced TD. The results therefore recommended that supplementation of RBO may be useful in the HP-induced TD. The findings have also potential implication in the treatment of schizophrenia and motor disorders.

  3. The metoclopramide black box warning for tardive dyskinesia: effect on clinical practice, adverse event reporting, and prescription drug lawsuits.

    PubMed

    Ehrenpreis, Eli D; Deepak, Parakkal; Sifuentes, Humberto; Devi, Radha; Du, Hongyan; Leikin, Jerrold B

    2013-06-01

    We examined the effects of the black box warning about the risk of tardive dyskinesia (TD) with chronic use of metoclopramide on management of gastroparesis within a single clinical practice, and on reporting of adverse events. Medical records of gastroparesis patients were evaluated for physician management choices. The FDA Adverse Event Reporting System (FAERS) was analyzed for event reports, and for lawyer-initiated reports, with metoclopramide from 2004 to 2010. Google Scholar was searched for court opinions against metoclopramide manufacturers. Before the black box warning, 69.8% of patients received metoclopramide for gastroparesis, compared with 23.7% after the warning. Gastroenterologists prescribed domperidone more often after than before the warning. Metoclopramide prescriptions decreased after 2008. Adverse event reporting increased after the warning. Only 3.6% of all FAERS reports but 70% of TD reports were filed by lawyers, suggesting a distortion in signal. Forty-seven legal opinions were identified, 33 from 2009-2010. The black box warning for metoclopramide has decreased its usage and increased its rate of adverse event reporting. Lawyer-initiated reports of TD hinder pharmacovigilance.

  4. Effect of Antipsychotic Type and Dose Changes on Tardive Dyskinesia and Parkinsonism Severity in Patients With a Serious Mental Illness: The Curaçao Extrapyramidal Syndromes Study XII.

    PubMed

    Mentzel, Charlotte L; Bakker, P Roberto; van Os, Jim; Drukker, Marjan; Matroos, Glenn E; Hoek, Hans W; Tijssen, Marina A J; van Harten, Peter N

    2017-03-01

    To test the efficacy of current treatment recommendations for parkinsonism and tardive dyskinesia (TD) severity in patients with severe mental illness (SMI). We present an 18-year prospective study including all 223 patients with SMI (as defined by the 1987 US National Institute of Mental Health, which were based on DSM-III-R diagnostic criteria) receiving care from the only psychiatric hospital of the former Netherlands Antilles. Eight clinical assessments (1992-2009) focused on movement disorders and medication use. Tardive dyskinesia was measured by the Abnormal Involuntary Movement Scale and parkinsonism by the Unified Parkinson's Disease Rating Scale. Antipsychotics were classified into first-generation antipsychotic (FGA) versus second-generation antipsychotic (SGA) and high versus low dopamine 2 (D₂) affinity categories. The effect that switching has within each category on subsequent movement scores was calculated separately by using time-lagged multilevel logistic regression models. There was a significant association between reduction in TD severity and starting/switching to an FGA (B = -3.54, P < .001) and starting/switching to a high D₂ affinity antipsychotic (B = -2.49, P < .01). Adding an SGA to existing FGA treatment was associated with reduction in TD severity (B = -2.43, P < .01). For parkinsonism, stopping antipsychotics predicted symptom reduction (B = -7.76, P < .01 in FGA/SGA-switch model; B = -7.74, P < .01 in D₂ affinity switch model), while starting a high D₂ affinity antipsychotic predicted an increase in symptoms (B = 3.29, P < .05 in D₂ affinity switch model). The results show that switching from an FGA to an SGA does not necessarily result in a reduction of TD or parkinsonism. Only stopping all antipsychotics reduces the severity of parkinsonism, and starting an FGA or a high D₂ affinity antipsychotic may reduce the severity of TD. © Copyright 2017 Physicians Postgraduate Press, Inc.

  5. Report: Protective effects of rice bran oil in haloperidol-induced tardive dyskinesia and serotonergic responses in rats.

    PubMed

    Samad, Noreen; Haleem, Muhammad Abdul; Haleem, Darakhshan Jabeen

    2016-07-01

    Effect of administration of Rice bran oil (RBO) was evaluated on haloperidol elicited tardive dyskinesia in rats. Albino Wistar rats treated with haloperidol in drinking water at a dose of 0.2mg/kg/day and RBO by oral tubes at a dose of 0.4 mL/day for 5 weeks. Motor coordination, VCMs and 8-hydroxy-2-(di-n-propylamino) tetraline)[8-OH-DPAT] _syndrome were monitored. Striatal serotonin (5-hydroxytryptamine; 5-HT) and 5-hydroxyindolacetic acid (5-HIAA) levels were determined by high performance liquid chromatography (HPLC-EC). Rats treated with haloperidol orally at a dose of for a period of 5 weeks developed VCMs, which increased progressively as the treatment continued for 5 weeks. Motor coordination impairment started after the 1st week and was maximally impaired after 3 weeks and gradually returned to the 1st week value. Co-administration of RBO prevented haloperidol_induced VCMs as well impairment of motor coordination. The intensity of 8-OH-DPAT_induced syndrome and decreased 5-HT metabolism were greater in water + haloperidol treated animals than RBO + haloperidol treated animals. The present study suggested that involvement of free radical in the development of TD and point to RBO as a possible therapeutic option to treat this hyperkinetic motor disorder.

  6. Prevalence of extrapyramidal syndromes in psychiatric inpatients and the relationship of clozapine treatment to tardive dyskinesia.

    PubMed

    Modestin, J; Stephan, P L; Erni, T; Umari, T

    2000-05-05

    In 200 inpatients on regular neuroleptics, point prevalence of extrapyramidal syndromes, including Parkinson syndrome, akathisia and tardive dyskinesia (TD), was studied and found to be 20, 11 and 22%, respectively. A total of 46 patients have currently, and for a longer time, (average about 3years, median over 1year) been treated with clozapine, and 127 with typical neuroleptics (NLs). Comparing both groups, higher TD scores were found in the clozapine sample. Investigating the influence of a set of seven clinical variables on the TD score with the help of multiple regression analysis, the influence of the treatment modality disappeared, whereas the age proved to be the only significant variable. Studying the role of past clozapine therapy in patients currently on typical NLs and comparing 10 matched pairs of chronic patients with and without TD in whom a complete life-time cumulative dose of NLs was identified, a relationship between TD and length of current typical NL therapy and life-time typical NL dosage could be demonstrated. On the whole, long-term relatively extensive use of clozapine has not markedly reduced the prevalence of extrapyramidal syndromes in our psychiatric inpatient population. In particular, we failed to demonstrate a beneficial effect of clozapine on prevalence of TD. There are certainly patients who suffer from TD in spite of a long-term intensive clozapine treatment.

  7. Privacy Impact Assessment for the TRIO Programs Annual Performance Report (APR) System

    ERIC Educational Resources Information Center

    US Department of Education, 2008

    2008-01-01

    The TRIO Programs Annual Performance Report (APR) System collects individual student records on individuals served by the following Federal TRIO Programs: Upward Bound (which includes regular Upward Bound (UB), Upward Bound Math-Science (UBMS), and Veterans Upward Bound (VUB)); Student Support Services (SSS); and the Ronald E. McNair Post…

  8. Vitamin E for antipsychotic-induced tardive dyskinesia.

    PubMed

    Soares-Weiser, Karla; Maayan, Nicola; Bergman, Hanna

    2018-01-17

    Antipsychotic (neuroleptic) medication is used extensively to treat people with chronic mental illnesses. Its use, however, is associated with adverse effects, including movement disorders such as tardive dyskinesia (TD) - a problem often seen as repetitive involuntary movements around the mouth and face. Vitamin E has been proposed as a treatment to prevent or decrease TD. The primary objective was to determine the clinical effects of vitamin E in people with schizophrenia or other chronic mental illness who had developed antipsychotic-induced TD.The secondary objectives were:1. to examine whether the effect of vitamin E was maintained as duration of follow-up increased;2. to test the hypothesis that the use of vitamin E is most effective for those with early onset TD (less than five years) SEARCH METHODS: We searched the Cochrane Schizophrenia Group Trials Register (July 2015 and April 2017), inspected references of all identified studies for further trials and contacted authors of trials for additional information. We included reports if they were controlled trials dealing with people with antipsychotic-induced TD and schizophrenia who remained on their antipsychotic medication and had been randomly allocated to either vitamin E or to a placebo, no intervention, or any other intervention. We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early had no improvement. We assessed risk of bias and created a 'Summary of findings' table using GRADE. The review now includes 13 poorly reported randomised trials (total 478 people), all participants were adults with chronic psychiatric disorders, mostly schizophrenia, and antipsychotic-induced TD. There was no clear difference between vitamin E and placebo for the outcome of TD: not improved to a clinically important extent (6 RCTs, N = 264, RR 0.95, 95% CI 0.89 to 1.01, low-quality evidence

  9. Sulphur flux through the sulphate assimilation pathway is differently controlled by adenosine 5'-phosphosulphate reductase under stress and in transgenic poplar plants overexpressing gamma-ECS, SO, or APR.

    PubMed

    Scheerer, Ursula; Haensch, Robert; Mendel, Ralf R; Kopriva, Stanislav; Rennenberg, Heinz; Herschbach, Cornelia

    2010-01-01

    Sulphate assimilation provides reduced sulphur for the synthesis of cysteine, methionine, and numerous other essential metabolites and secondary compounds. The key step in the pathway is the reduction of activated sulphate, adenosine 5'-phosphosulphate (APS), to sulphite catalysed by APS reductase (APR). In the present study, [(35)S]sulphur flux from external sulphate into glutathione (GSH) and proteins was analysed to check whether APR controls the flux through the sulphate assimilation pathway in poplar roots under some stress conditions and in transgenic poplars. (i) O-Acetylserine (OAS) induced APR activity and the sulphur flux into GSH. (ii) The herbicide Acetochlor induced APR activity and results in a decline of GSH. Thereby the sulphur flux into GSH or protein remained unaffected. (iii) Cd treatment increased APR activity without any changes in sulphur flux but lowered sulphate uptake. Several transgenic poplar plants that were manipulated in sulphur metabolism were also analysed. (i) Transgenic poplar plants that overexpressed the gamma-glutamylcysteine synthetase (gamma-ECS) gene, the enzyme catalysing the key step in GSH formation, showed an increase in sulphur flux into GSH and sulphate uptake when gamma-ECS was targeted to the cytosol, while no changes in sulphur flux were observed when gamma-ECS was targeted to plastids. (ii) No effect on sulphur flux was observed when the sulphite oxidase (SO) gene from Arabidopsis thaliana, which catalyses the back reaction of APR, that is the reaction from sulphite to sulphate, was overexpressed. (iii) When Lemna minor APR was overexpressed in poplar, APR activity increased as expected, but no changes in sulphur flux were observed. For all of these experiments the flux control coefficient for APR was calculated. APR as a controlling step in sulphate assimilation seems obvious under OAS treatment, in gamma-ECS and SO overexpressing poplars. A possible loss of control under certain conditions, that is Cd treatment

  10. Success of tardive electroconvulsive therapy sessions after loxapine-induced malignant syndrome in the context of very poor metabolisation.

    PubMed

    Descoeur, Juliette; Philibert, Laurent; Chalard, Kevin; Attal, Jérôme; Petit, Pierre; Klouche, Kada; Olivier, Mathieu

    2017-12-01

    We report the success of tardive electroconvulsive therapy in a case of loxapine malignant syndrome with catatonia. Loxapine and its metabolites were measured in biological samples by liquid chromatography coupled to tandem mass spectrometry. Genes were studied by sequencing and quantitative polymerase chain reaction (PCR). Plasmatic drug concentrations showed a supratherapeutic concentration of loxapine with a very low 8-hydroxyloxapine/loxapine ratio (range from 0.32 to 0.66, normal value>2 for 100mg) and a very long elimination half-life of loxapine (half-life>140h, normal value from 1 to 4hours). We tried to explain this kinetics by exploring the main pharmacogenes implicated in the metabolism of loxapine. No genetic abnormality for CYP1A2 was observed. The study of associated treatments showed the potential contribution of valproate. Pharmacokinetics and pharmacogenetics investigations revealed a blockade of the CYP1A2 metabolic pathway without genetic abnormalities, probably due to valproate co-medication. Toxicological monitoring of loxapine and its metabolites helped to explain the persistence of symptoms and to adapt the therapeutic management. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  11. Haloperidol-induced striatal Nur77 expression in a non-human primate model of tardive dyskinesia

    PubMed Central

    Mahmoudi, Souha; Blanchet, Pierre J.; Lévesque, Daniel

    2015-01-01

    Tardive dyskinesia (TD) is a delayed and potentially irreversible motor complication arising in patients chronically exposed to antipsychotic drugs. As several modern (so-called atypical) antipsychotic drugs are common offenders, the widening clinical indications for prescription as well as exposure of vulnerable individuals, TD will remain a significant drug-induced unwanted side effect. In addition, the pathophysiology of TD remains elusive and therapeutics difficult. Based on rodent experiments, we have previously shown that the transcriptional factor Nur77 (also known as NGFI-B or Nr4a1) is induced in the striatum following antipsychotic drug exposure as part of a long-term neuroadaptive process. To confirm this, we exposed adult capuchin (Cebus apella) monkeys to prolonged treatments with haloperidol (median 18.5 months, N=11) or clozapine (median 6 months, N=6). Six untreated animals were used as controls. Six haloperidol-treated animals developed mild TD movements similar to those found in humans. No TD was observed in the clozapine group. Postmortem analysis of Nur77 expression measured by in situ hybridization revealed a stark contrast between the two drugs, as Nur77 mRNA levels in the caudate-putamen were strongly upregulated in animals exposed to haloperidol while spared following clozapine treatment. Interestingly, within the haloperidol-treated group, TD-free animals showed higher Nur77 expression in putamen subterritories compared to dyskinetic animals. This suggests that Nur77 expression might be associated with a reduced risk to TD in this experimental model and could provide a novel target for drug intervention. PMID:23551242

  12. Complex regulation of AprA metalloprotease in Pseudomonas fluorescens M114: evidence for the involvement of iron, the ECF sigma factor, PbrA and pseudobactin M114 siderophore.

    PubMed

    Maunsell, Bláithín; Adams, Claire; O'Gara, Fergal

    2006-01-01

    In the soil bacterium Pseudomonas fluorescens M114, extracellular proteolytic activity and fluorescent siderophore (pseudobactin M114) production were previously shown to be co-ordinately negatively regulated in response to environmental iron levels. An iron-starvation extracytoplasmic function sigma factor, PbrA, required for the transcription of siderophore biosynthetic genes, was also implicated in M114 protease regulation. The current study centred on the characterization and genetic regulation of the gene(s) responsible for protease production in M114. A serralysin-type metalloprotease gene, aprA, was identified and found to encode the major, if not only, extracellular protease produced by this strain. The expression of aprA and its protein product were found to be subject to complex regulation. Transcription analysis confirmed that PbrA was required for full aprA transcription under low iron conditions, while the ferric uptake regulator, Fur, was implicated in aprA repression under high iron conditions. Interestingly, the iron regulation of AprA was dependent on culture conditions, with PbrA-independent AprA-mediated proteolytic activity observed on skim milk agar supplemented with yeast extract, when supplied with iron or purified pseudobactin M114. These effects were not observed on skim milk agar without yeast extract. PbrA-independent aprA expression was also observed from a truncated transcriptional fusion when grown in sucrose asparagine tryptone broth supplied with iron or purified pseudobactin M114. Thus, experimental evidence suggested that iron mediated its effects via transcriptional activation by PbrA under low iron conditions, while an as-yet-unidentified sigma factor(s) may be required for the PbrA-independent aprA expression and AprA proteolytic activity induced by siderophore and iron.

  13. Expression, purification, and characterization of the Necator americanus aspartic protease-1 (Na-APR-1 (M74)) antigen, a component of the bivalent human hookworm vaccine.

    PubMed

    Seid, Christopher A; Curti, Elena; Jones, R Mark; Hudspeth, Elissa; Rezende, Wanderson; Pollet, Jeroen; Center, Lori; Versteeg, Leroy; Pritchard, Sonya; Musiychuk, Konstantin; Yusibov, Vidadi; Hotez, Peter J; Bottazzi, Maria Elena

    2015-01-01

    Over 400 million people living in the world's poorest developing nations are infected with hookworms, mostly of the genus Necator americanus. A bivalent human hookworm vaccine composed of the Necator americanus Glutathione S-Transferase-1 (Na-GST-1) and the Necator americanus Aspartic Protease-1 (Na-APR-1 (M74)) is currently under development by the Sabin Vaccine Institute Product Development Partnership (Sabin PDP). Both monovalent vaccines are currently in Phase 1 trials. Both Na-GST-1 and Na-APR-1 antigens are expressed as recombinant proteins. While Na-GST-1 was found to express with high yields in Pichia pastoris, the level of expression of Na-APR-1 in this host was too low to be suitable for a manufacturing process. When the tobacco plant Nicotiana benthamiana was evaluated as an expression system, acceptable levels of solubility, yield, and stability were attained. Observed expression levels of Na-APR-1 (M74) using this system are ∼300 mg/kg. Here we describe the achievements and obstacles encountered during process development as well as characterization and stability of the purified Na-APR-1 (M74) protein and formulated vaccine. The expression, purification and analysis of purified Na-APR-1 (M74) protein obtained from representative 5 kg reproducibility runs performed to qualify the Na-APR-1 (M74) production process is also presented. This process has been successfully transferred to a pilot plant and a 50 kg scale manufacturing campaign under current Good Manufacturing Practice (cGMP) has been performed. The 50 kg run has provided a sufficient amount of protein to support the ongoing hookworm vaccine development program of the Sabin PDP.

  14. Cholinergic medication for antipsychotic-induced tardive dyskinesia.

    PubMed

    Tammenmaa-Aho, Irina; Asher, Rosie; Soares-Weiser, Karla; Bergman, Hanna

    2018-03-19

    Tardive dyskinesia (TD) remains a troublesome adverse effect of conventional antipsychotic (neuroleptic) medication. It has been proposed that TD could have a component of central cholinergic deficiency. Cholinergic drugs have been used to treat TD. To determine the effects of cholinergic drugs (arecoline, choline, deanol, lecithin, meclofenoxate, physostigmine, RS 86, tacrine, metoxytacrine, galantamine, ipidacrine, donepezil, rivastigmine, eptastigmine, metrifonate, xanomeline, cevimeline) for treating antipsychotic-induced TD in people with schizophrenia or other chronic mental illness. An electronic search of the Cochrane Schizophrenia Group's Study-Based Register of Trials (16 July 2015 and April 2017) was undertaken. This register is assembled by extensive searches for randomised controlled trials in many electronic databases, registers of trials, conference proceedings and dissertations. References of all identified studies were searched for further trial citations. We included reports identified by the search if they were of controlled trials involving people with antipsychotic-induced TD and chronic mental illness, who had been randomly allocated to either a cholinergic agent or to a placebo or no intervention. Two review authors independently assessed the methodological quality of the trials. Two review authors extracted data and, where possible, estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We analysed data on an intention-to-treat basis, with the assumption that people who left early had no improvement. We assessed risk of bias and created a 'Summary of findings' table using GRADE. We included 14 studies investigating the use of cholinergic drugs compared with placebo published between 1976 and 2014. All studies involved small numbers of participants (five to 60 people). Three studies that investigated the new cholinergic Alzheimer drugs for the treatment of TD are new to this update. Overall, the risk of bias

  15. Les recommandations thérapeutiques relatives aux effets secondaires extrapyramidaux associés à l’utilisation d’antipsychotiques de deuxième génération chez les enfants et les adolescents

    PubMed Central

    Pringsheim, Tamara; Doja, Asif; Belanger, Stacey; Patten, Scott

    2012-01-01

    HISTORIQUE ET OBJECTIF : L’utilisation d’antipsychotiques augmente chez les enfants. Le présent article visait à orienter les cliniciens quant à la prise en charge clinique des effets secondaires extrapyramidaux des antipsychotiques de deuxième génération. MÉTHODOLOGIE : Les publications, les entrevues avec des informateurs clés et des échanges avec les membres d’un groupe de discussion et les partenaires ont permis de déterminer les principaux secteurs cliniques d’orientation et les préférences quant à la structure des présentes recommandations. Les membres responsables des lignes directrices ont reçu le projet de recommandations, ont évalué l’information recueillie grâce à une analyse bibliographique systématique et ont utilisé un processus de groupe nominal pour parvenir à un consensus quant aux recommandations thérapeutiques. Les lignes directrices contiennent une description des anomalies neurologiques souvent observées avec l’utilisation d’antipsychotiques ainsi que les recommandations sur le moyen d’examiner et de quantifier ces anomalies. Une démarche séquentielle sur la prise en charge des anomalies neurologiques est présentée. RÉSULTATS : On peut observer plusieurs types de symptômes extrapyramidaux attribuables à l’utilisation d’antipsychotiques chez les enfants, y compris la dystonie aiguë, l’akathisie, le parkinsonisme et la dyskinésie tardive, toutes induites par les neuroleptiques, de même que la dystonie tardive, l’akathisie tardive et les dyskinésies de sevrage. La forte majorité des données probantes sur le traitement des troubles du mouvement induits par les antipsychotiques proviennent de patients adultes atteints de schizophrénie. Étant donné le peu de données pédiatriques, les recommandations découlent de publications portant tant sur des adultes que sur des enfants. Compte tenu des limites de généralisation des données provenant de sujets adultes pour des enfants, il

  16. Anesthésie pour prothése totale de la hanche: à propos de 50 cas

    PubMed Central

    Serghini, Issam; Qamouss, Youssef; Zoubir, Mohamed; Lalaoui, Jaafar Salim; Koulali, Idrissi Khalid; Boughalem, Mohamed

    2015-01-01

    La chirurgie de la prothèse totale de la hanche (PTH) est une chirurgie fonctionnelle qui consiste en un remplacement d'une articulation endommagée afin d'améliorer la qualité de vie du patient. L'anesthésie pour PTH exige une préparation rigoureuse à l'intervention, la consultation d'anesthésie sera donc la clef de cette réussite. Nous avons réalisé une étude rétrospective concernant 60 arthroplasties totales de la hanche implantées chez 50 patients adultes, colligée au sevice de Traumatologie et de chirurgie orthopédique à l'Hôpital Militaire Avicenne de Marrakech sur une période étalée de Janvier 2010 au Décembre 2012. Nous avons évalué la prise en charge anesthésique: pré, per et postopératoire des patients opérés pour une PTH. La moyenne d’âge était de 56,5 ans, le sex-ratio était de 1,63 en faveur des hommes. L'indication prédominante était la coxarthrose primitive. L'anesthésie générale était la technique anesthésique la plus utilisée (66% des cas), l'intubation difficile était rencontrée chez 6% de nos patients. La durée moyenne de l'acte chirurgical était de 114 +/- 25,33 mn. 12% de nos patients ont présenté une hypotension artérielle peropératoire. L'incidence de la transfusion homologue perop était de 14%. Nous avons noté 08 cas de complications postop: 03 cas d'infection de la PTH 15 jours après l'intervention, 03 cas de descellement aseptique, 01 cas de luxation de PTH et 01 cas de descellement septique avec un recul moyen de 54 mois. PMID:27047619

  17. Using a Classroom Response System to Improve Multiple-Choice Performance in AP[R] Physics

    ERIC Educational Resources Information Center

    Bertrand, Peggy

    2009-01-01

    Participation in rigorous high school courses such as Advanced Placement (AP[R]) Physics increases the likelihood of college success, especially for students who are traditionally underserved. Tackling difficult multiple-choice exams should be part of any AP program because well-constructed multiple-choice questions, such as those on AP exams and…

  18. Intérêt de la scintigraphie lymphatique et place de la chirurgie dans les chylothorax congénitaux

    PubMed Central

    Methlouthi, Jihène; Mahdhaoui, Nabiha; Bellalah, Manel; Selsabil, Nouir; Hedia, Ayache; Sfar, Raja; Essabah, Habib; Abdellatif, Nouri; Sonia, Nouri; Hassen, Seboui

    2016-01-01

    Le chylothorax est défini par l'accumulation du liquide lymphatique dans la cavité pleurale. Il existe 3 catégories distinctes chez le nouveau-né: les chylothorax congénitaux (CC), les chylothorax malformatifs ou syndromiques (CM) et les chylothorax post-opératoires (CO). Bien que rare, le chylothorax représente la cause la plus fréquente des épanchements pleuraux en période néonatale. Son diagnostic positif est facile par analyse du liquide pleural, mais son mécanisme et surtout l'intégrité du canal thoracique et ses collatérales est parfois difficile à préciser. La lymphoscintigraphie représente l'examen de choix dans le diagnostic etipathogénique. Ce moyen de diagnostic peut être couplé, si possible, au SPECT-CT (single photon emission tomography/computed tomography) permettant de donner des renseignements plus précis, notamment sur le plan anatomique. Sa prise en charge repose sur le drainage du liquide pleural, la suppression des graisses alimentaires et la nutrition parentérale. Le recours à la chirurgie est préconisé devant l'échec du traitement médical. Nous rapportons l'observation d'un nouveau-né porteur d'un chylothorax unilatéral, n'ayant pas répondu au traitement médical. La lymphoscintigraphie avait permis de diagnostiquer le mécanisme étiopathogénique et par conséquent, de guider le traitement chirurgical. PMID:28154676

  19. Advanced Design Features of APR1400 and Realization in Shin Kori Construction Project

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

    OH, S.J.; Park, K.C.; Kim, H.G.

    2006-07-01

    APR1400 adopted several advanced design features. To ensure their proper operation as a part of ShinKori 3,4 project, both experimental and analytical work are continuing. In this paper, work on the advanced design features related to enhanced safety is examined. APR1400 safety injection system consists of four independent trains which include four safety injection pump and tanks. A passive flow regulating device called fluidic device is installed in the safety injection tanks. Separate effect tests including a full scale fluidic device tests have been conducted. Integral system tests are in progress. Combination of these work with the analytical work usingmore » RELAP5/Mod3 would ensure the proper operation of the new safety injection systems. To mitigate severe accidents, hydrogen mitigation system using PARs and igniters is adopted. Also, active injection system and the streamlined insulation design are adopted to enhance the in-vessel retention capability with the external cooling of RPV strategy. Analytic work with supporting experiments is performed. We are certain that these preparatory work would help the successful adaptation of ADF in ShinKori project. (authors)« less

  20. 23. "GAFFTC 20 APR 60, H65A F106A; ESCAPE SYSTEM RUN ...

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

    23. "G-AFFTC 20 APR 60, H-6-5A F-106A; ESCAPE SYSTEM RUN 5A." Testing the ejection system on a Convair sled. - Edwards Air Force Base, South Base Sled Track, Edwards Air Force Base, North of Avenue B, between 100th & 140th Streets East, Lancaster, Los Angeles County, CA

  1. Striatal cholinergic interneurons and D2 receptor-expressing GABAergic medium spiny neurons regulate tardive dyskinesia.

    PubMed

    Bordia, Tanuja; Zhang, Danhui; Perez, Xiomara A; Quik, Maryka

    2016-12-01

    Tardive dyskinesia (TD) is a drug-induced movement disorder that arises with antipsychotics. These drugs are the mainstay of treatment for schizophrenia and bipolar disorder, and are also prescribed for major depression, autism, attention deficit hyperactivity, obsessive compulsive and post-traumatic stress disorder. There is thus a need for therapies to reduce TD. The present studies and our previous work show that nicotine administration decreases haloperidol-induced vacuous chewing movements (VCMs) in rodent TD models, suggesting a role for the nicotinic cholinergic system. Extensive studies also show that D2 dopamine receptors are critical to TD. However, the precise involvement of striatal cholinergic interneurons and D2 medium spiny neurons (MSNs) in TD is uncertain. To elucidate their role, we used optogenetics with a focus on the striatum because of its close links to TD. Optical stimulation of striatal cholinergic interneurons using cholineacetyltransferase (ChAT)-Cre mice expressing channelrhodopsin2-eYFP decreased haloperidol-induced VCMs (~50%), with no effect in control-eYFP mice. Activation of striatal D2 MSNs using Adora2a-Cre mice expressing channelrhodopsin2-eYFP also diminished antipsychotic-induced VCMs, with no change in control-eYFP mice. In both ChAT-Cre and Adora2a-Cre mice, stimulation or mecamylamine alone similarly decreased VCMs with no further decline with combined treatment, suggesting nAChRs are involved. Striatal D2 MSN activation in haloperidol-treated Adora2a-Cre mice increased c-Fos + D2 MSNs and decreased c-Fos + non-D2 MSNs, suggesting a role for c-Fos. These studies provide the first evidence that optogenetic stimulation of striatal cholinergic interneurons and GABAergic MSNs modulates VCMs, and thus possibly TD. Moreover, they suggest nicotinic receptor drugs may reduce antipsychotic-induced TD. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Striatal cholinergic interneurons and D2 receptor-expressing GABAergic medium spiny neurons regulate tardive dyskinesia

    PubMed Central

    Bordia, Tanuja; Zhang, Danhui; Perez, Xiomara A.; Quik, Maryka

    2016-01-01

    Tardive dyskinesia (TD) is a drug-induced movement disorder that arises with antipsychotics. These drugs are the mainstay of treatment for schizophrenia and bipolar disorder, and are also prescribed for major depression, autism, attention deficit hyperactivity, obsessive compulsive and post-traumatic stress disorder. There is thus a need for therapies to reduce TD. The present studies and our previous work show that nicotine administration decreases haloperidol-induced vacuous chewing movements (VCMs) in rodent TD models, suggesting a role for the nicotinic cholinergic system. Extensive studies also show that D2 dopamine receptors are critical to TD. However, the precise involvement of striatal cholinergic interneurons and D2 medium spiny neurons (MSNs) in TD is uncertain. To elucidate their role, we used optogenetics with a focus on the striatum because of its close links to TD. Optical stimulation of striatal cholinergic interneurons using cholineacetyltransferase (ChAT)-Cre mice expressing channelrhodopsin2-eYFP decreased haloperidol-induced VCMs (~50%), with no effect in control-eYFP mice. Activation of striatal D2 MSNs using Adora2a-Cre mice expressing channelrhodopsin2-eYFP also diminished antipsychotic-induced VCMs, with no change in control-eYFP mice. In both ChAT-Cre and Adora2a-Cre mice, stimulation or mecamylamine alone similarly decreased VCMs with no further decline with combined treatment, suggesting nAChRs are involved. Striatal D2 MSN activation in haloperidol-treated Adora2a-Cre mice increased c-Fos+ D2 MSNs and decreased c-Fos+ non-D2 MSNs, suggesting a role for c-Fos. These studies provide the first evidence that optogenetic stimulation of striatal cholinergic interneurons and GABAergic MSNs modulates VCMs, and thus possibly TD. Moreover, they suggest nicotinic receptor drugs may reduce antipsychotic-induced TD. PMID:27658674

  3. Processing of High Resolution, Multiparametric Radar Data for the Airborne Dual-Frequency Precipitation Radar APR-2

    NASA Technical Reports Server (NTRS)

    Tanelli, Simone; Meagher, Jonathan P.; Durden, Stephen L.; Im, Eastwood

    2004-01-01

    Following the successful Precipitation Radar (PR) of the Tropical Rainfall Measuring Mission, a new airborne, 14/35 GHz rain profiling radar, known as Airborne Precipitation Radar - 2 (APR-2), has been developed as a prototype for an advanced, dual-frequency spaceborne radar for a future spaceborne precipitation measurement mission. . This airborne instrument is capable of making simultaneous measurements of rainfall parameters, including co-pol and cross-pol rain reflectivities and vertical Doppler velocities, at 14 and 35 GHz. furthermore, it also features several advanced technologies for performance improvement, including real-time data processing, low-sidelobe dual-frequency pulse compression, and dual-frequency scanning antenna. Since August 2001, APR-2 has been deployed on the NASA P3 and DC8 aircrafts in four experiments including CAMEX-4 and the Wakasa Bay Experiment. Raw radar data are first processed to obtain reflectivity, LDR (linear depolarization ratio), and Doppler velocity measurements. The dataset is then processed iteratively to accurately estimate the true aircraft navigation parameters and to classify the surface return. These intermediate products are then used to refine reflectivity and LDR calibrations (by analyzing clear air ocean surface returns), and to correct Doppler measurements for the aircraft motion. Finally, the the melting layer of precipitation is detected and its boundaries and characteristics are identifIed at the APR-2 range resolution of 30m. The resulting 3D dataset will be used for validation of other airborne and spaceborne instruments, development of multiparametric rain/snow retrieval algorithms and melting layer characterization and statistics.

  4. Behavioral and neurochemical effects of alpha lipoic acid associated with omega-3 in tardive dyskinesia induced by chronic haloperidol in rats.

    PubMed

    de Araújo, Dayane Pessoa; Camboim, Thaisa Gracielle Martins; Silva, Ana Patrícia Magalhães; Silva, Caio da Fonseca; de Sousa, Rebeca Canuto; Barbosa, Mabson Delâno Alves; Oliveira, Lucidio Clebeson; Cavalcanti, José Rodolfo Lopes de Paiva; Lucena, Eudes Euler de Souza; Guzen, Fausto Pierdoná

    2017-07-01

    Tardive dyskinesia (TD) is characterized by involuntary movements of the lower portion of the face being related to typical antipsychotic therapy. TD is associated with the oxidative imbalance in the basal ganglia. Lipoic acid (LA) and omega-3 (ω-3) are antioxidants acting as enzyme cofactors, regenerating antioxidant enzymes. This study aimed to investigate behavioral and neurochemical effects of supplementation with LA (100 mg/kg) and ω-3 (1 g/kg) in the treatment of TD induced by chronic use of haloperidol (HAL) (1 mg/kg) in rats. Wistar male rats were used, weighing between 180-200 g. The animals were treated chronically (31 days) with LA alone or associated with HAL or ω-3. Motor behavior was assessed by open-field test, the catalepsy test, and evaluation of orofacial dyskinesia. Oxidative stress was accessed by determination of lipid peroxidation and concentration of nitrite. LA and ω-3 alone or associated caused an improvement in motor performance by increasing locomotor activity in the open-field test and decreased the permanence time on the bar in the catalepsy test and decreased the orofacial dyskinesia. LA and ω-3 showed antioxidant effects, decreasing lipid peroxidation and nitrite levels. Thus, the use of LA associated with ω-3 reduced the extrapyramidal effects produced by chronic use of HAL.

  5. Monitoring the impact of an aspartic protease (MpAPr1) on grape proteins and wine properties.

    PubMed

    Theron, Louwrens Wiid; Bely, Marina; Divol, Benoit

    2018-04-23

    The perception of haze in wine is brought about when pathogenesis-related proteins become unstable and aggregate, subsequently resulting in crosslinking until it develops into light-dispersing particles. Elimination of these proteins is usually achieved via bentonite fining, which, although effective, suffers from several drawbacks. The utilization of proteases has been proposed as an ideal alternative. In a previous study, an aspartic protease (MpAPr1) from the yeast Metschnikowia pulcherrima was purified and shown to be partially active against grape proteins in synthetic medium. In this study, the effects of pure MpAPr1 supplemented to Sauvignon Blanc juice on subsequent fermentation were investigated. The juice was incubated for 48 h and thereafter inoculated with Saccharomyces cerevisiae. Results revealed that the enzyme had no observable effects on fermentation performance and retained activity throughout. Protein degradation could be detected and resulted in a significant modification of the wine composition and an increase in the presence of certain volatile compounds, especially those linked to amino acid metabolism.

  6. Does intraoperative neuromonitoring of recurrent nerves have an impact on the postoperative palsy rate? Results of a prospective multicenter study.

    PubMed

    Mirallié, Éric; Caillard, Cécile; Pattou, François; Brunaud, Laurent; Hamy, Antoine; Dahan, Marcel; Prades, Michel; Mathonnet, Muriel; Landecy, Gérard; Dernis, Henri-Pierre; Lifante, Jean-Christophe; Sebag, Frederic; Jegoux, Franck; Babin, Emmanuel; Bizon, Alain; Espitalier, Florent; Durand-Zaleski, Isabelle; Volteau, Christelle; Blanchard, Claire

    2018-01-01

    neuromonitoring does not decrease postoperative recurrent laryngeal nerve palsy rate. Due to its high specificity, however, intraoperative neuromonitoring is useful to predict normal vocal cord mobility. From the CHU de Nantes, a Clinique de Chirurgie Digestive et Endocrinienne, Nantes, France; CHU Lille, Université de Lille, b Chirurgie Générale et Endocrinienne, Lille, France; CHU Nancy-Hôpital de Brabois, c Service de Chirurgie Digestive, Hépato-Biliaire, et Endocrinienne, Nancy, France; CHU Angers, d Chirurgie Digestive et Endocrinienne, Angers, France; CHU de Toulouse-Hôpital Larrey, e Chirurgie Thoracique, Pôle Voies Respiratoires, Toulouse; CHU Saint-Etienne-Hôpital Nord, f ORL et Chirurgie Cervico-Faciale et Plastique, Saint-Etienne, France; CHU de Limoges-Hôpital Dupuytren, g Chirurgie Digestive, Générale et Endocrinienne, Limoges, France; CHU de Besançon-Hôpital Jean Minjoz, h Chirurgie Digestive, Besançon, France; Centre Hospitalier du Mans, i Service ORL et Chirurgie Cervico-Faciale, Le Mans, France; Centre Hospitalier Lyon-Sud, j Chirurgie Générale, Endocrinienne, Digestive et Thoracique, Pierre Bénite, France; AP-HM-Hôpital de La Conception, k Chirurgie Générale, Marseille, France; CHU de Rennes-Hôpital Pontchaillou, l Service ORL et Chirurgie Maxillo-Faciale, Rennes, France; CHU de Caen, m ORL et Chirurgie Cervico-Faciale, Caen, France; CHU d'Angers, n ORL et Chirurgie Cervico-Faciale, Angers, France; CHU de Nantes, o Service ORL, Nantes, France; AP HP URCEco île-de-France, p hôpital de l'Hôtel-Dieu, Paris, France; DRCI, département Promotion, q Nantes, France. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Traitement chirurgical des métastases osseuses rachidiennes

    PubMed Central

    Saqui, Abderrazzak El; Aggouri, Mohamed; Benzagmout, Mohamed; Chakour, Khalid; Chaoui, Mohamed El Faiz

    2017-01-01

    La chirurgie de la métastase est une chirurgie palliative le plus souvent, surtout au niveau du rachis de par sa localisation anatomique. Cette chirurgie doit être bien préparée pour que les suites soient simples et que le traitement adjuvant soit fait dans les meilleurs délais. La stratégie thérapeutique doit être systématiquement prise en réunion de concertation pluridisciplinaire (RCP). Le principal risque de la localisation rachidienne est neurologique, c'est pourquoi cette chirurgie doit être préventive le plus souvent. Elle a pour objectif principal d'améliorer la qualité de vie. PMID:28533876

  8. Outcomes of patients with abdominoperineal resection (APR) and low anterior resection (LAR) who had very low rectal cancer.

    PubMed

    Yeom, Seung-Seop; Park, In Ja; Jung, Sung Woo; Oh, Se Heon; Lee, Jong Lyul; Yoon, Yong Sik; Kim, Chan Wook; Lim, Seok-Byung; Kim, Nayoung; Yu, Chang Sik; Kim, Jin Cheon

    2017-10-01

    We compared the oncological outcomes of sphincter-saving resection (SSR) and abdominoperineal resection (APR) in 409 consecutive patients with very low rectal cancer (i.e., tumors within 3 cm from the anal verge); 335 (81.9%) patients underwent APR and 74 (18.1%) underwent SSR. The APR group comprised higher proportions of men (67.5% vs 55.4%, P = .049) and advanced-stage patients (P < .001). Preoperative chemoradiotherapy (PCRT) was more frequently administered in the SSR group (83.8% vs 52.8%, P < .001). Overall, the systemic and local recurrence rates were 29.1% and 6.1%, respectively. On stratification according to PCRT and pathologic stage, the mode of surgery did not affect the recurrence type. Moreover, recurrence-free survival (RFS) did not differ according to the mode of surgery in different cancer stages. RFS was associated with ypT and ypN stages in patients who received PCRT, while pN stage, lymphovascular invasion (LVI), and circumferential resection margin (CRM) involvement were risk factors for RFS in those who did not receive PCRT. Notably, SSR was not found to be a risk factor for RFS in either subgroup. Patients who were stratified according to cancer stage and PCRT also showed no differences in RFS according to the mode of surgery. Our results demonstrate that, regardless of PCRT administration, SSR is an effective treatment for very low rectal cancer, while CRM is an important prognostic factor for patients who did not receive PCRT.

  9. A Bayesian inversion for slip distribution of 1 Apr 2007 Mw8.1 Solomon Islands Earthquake

    NASA Astrophysics Data System (ADS)

    Chen, T.; Luo, H.

    2013-12-01

    On 1 Apr 2007 the megathrust Mw8.1 Solomon Islands earthquake occurred in the southeast pacific along the New Britain subduction zone. 102 vertical displacement measurements over the southeastern end of the rupture zone from two field surveys after this event provide a unique constraint for slip distribution inversion. In conventional inversion method (such as bounded variable least squares) the smoothing parameter that determines the relative weight placed on fitting the data versus smoothing the slip distribution is often subjectively selected at the bend of the trade-off curve. Here a fully probabilistic inversion method[Fukuda,2008] is applied to estimate distributed slip and smoothing parameter objectively. The joint posterior probability density function of distributed slip and the smoothing parameter is formulated under a Bayesian framework and sampled with Markov chain Monte Carlo method. We estimate the spatial distribution of dip slip associated with the 1 Apr 2007 Solomon Islands earthquake with this method. Early results show a shallower dip angle than previous study and highly variable dip slip both along-strike and down-dip.

  10. M16. Valbenazine (NBI-98854) for the Treatment of Tardive Dyskinesia: Analysis by Underlying Psychiatric Diagnosis in Phase III KINECT 3 Study

    PubMed Central

    Josiassen, Richard; Kane, John; Burke, Joshua; Jimenez, Roland; Siegert, Scott; Liang, Grace

    2017-01-01

    Abstract Background: Valbenazine is a novel and highly selective vesicular monoamine transporter 2 (VMAT2) inhibitor that is being evaluated for the treatment of tardive dyskinesia (TD), a persistent movement disorder resulting from exposure to antipsychotics or other dopamine receptor blocking agents (DRBAs). The efficacy of valbenazine in treating TD was demonstrated in a Phase 3 clinical trial (KINECT 3; NCT02274558), which included subjects with underlying schizophrenia/schizoaffective disorder or mood disorder. Further analyses of data from that trial were conducted to explore the efficacy of valbenazine across diagnostic subgroups. Methods: Subjects in this 6-week, double-blind, placebo-controlled trial were randomized 1:1:1 to once-daily valbenazine 80 mg, valbenazine 40 mg, or placebo. The primary endpoint was change from baseline to Week 6 on the Abnormal Involuntary Movement Scale (AIMS) total score (items 1–7) for valbenazine 80 mg vs placebo in the intent-to-treat (ITT) population. AIMs were videotaped and ratings were conducted by central raters blind to study visit and group. Additional outcomes included AIMS total score change (40 mg vs placebo) and Clinical Global Impression of Change-Tardive Dyskinesia (CGI TD) score (80 and 40 mg vs placebo) at Week 6. In addition to being evaluated in the ITT population, these outcomes were analyzed in subgroups categorized by underlying psychiatric diagnosis (schizophrenia/schizoaffective disorder or mood disorder). Results: At Week 6 in the ITT population (N = 225), AIMS score improvement was significantly greater with valbenazine 80 mg than placebo (least squares [LS] mean change from baseline: 80 mg, 3.2; placebo, −0.1; P < .0001). AIMS score change at Week 6 for valbenazine 40 mg (1.9) was also greater than placebo (P = .0021). Statistical testing was not conducted in the subgroups, but the magnitude of AIMS improvement in these patients was comparable to results in the overall ITT

  11. Radionécrose cérébrale chez des patients irradiés pour cancers du nasopharynx: à propos de 3 cas

    PubMed Central

    El Mazghi, Abderrahman; Lalya, Issam; Loukili, Kaoutar; El Kacemi, Hanan; Kebdani, Taieb; Hassouni, Khalid

    2014-01-01

    La radionécrose cérébrale est une complication tardive, iatrogène, relativement rare de la radiothérapie qui survient après plus de six mois suivant le début du traitement. Elle pourrait s'expliquer par la conjonction de lésions vasculaires, gliales et d'ordre immunologiques. Elle peut mettre en jeu le pronostic fonctionnel et vital du malade. La prévention de cette affection redoutable est fondamentale vu l'absence de traitement potentiellement efficace. Nous rapportons 03 nouveaux cas, chez des patients traités par chimiothérapie d'induction puis radio- chimiothérapie concomitante pour des cancers localement avancés du nasopharynx. Le diagnostic a été orienté par l'IRM spectroscopique et l’évolution était favorable sous corticothérapie dans les 03 cas. PMID:25722784

  12. The Experience of Staging Nijinsky's "L'Apres-Midi d'un Faune" in a Higher Education Dance Program

    ERIC Educational Resources Information Center

    Curran, Tina

    2010-01-01

    This study documented the experiences of staging Vaslav Nijinsky's "L'Apres-midi d'un Faune" in a higher education dance program. The ballet was staged from Labanotation. Research questions focused on teaching and learning pedagogy, characterization of the process over time, experiences of the participants and teaching approaches. The project…

  13. T7. PHARMACOGENETIC OF TARDIVE DYSKINESIA -- A FOLLOW-UP ON THE VALBENAZINE TARGET VMAT2/SLC18A2

    PubMed Central

    Zai, Clement; Tiwari, Arun; Mueller, Daniel; Voineskos, Aristotle; Potkin, Steven G; Lieberman, Jeffrey; Meltzer, Herbert; Remington, Gary; Kennedy, James

    2018-01-01

    Abstract Background Tardive dyskinesia (TD) is a motor side effect that may arise after long-term treatment of antipsychotic drugs. Its etiology is not well understood, but a number of risk factors have been associated with TD. TD occurrence appears to be familial, thus suggesting a genetic component. We previously reported on an association between the SLC18A2 gene that codes for the vesicular monoamine transporter 2 (VMAT2) that packages monoamines including dopamine from the cytoplasm into synaptic vesicles (Zai et al, 2013). In the present study, we examined the dopamine transporter gene SLC6A3 by itself and in conjunction with SLC18A2 for possible association with TD. Methods We genotyped and analyzed the variable-number tandem repeat (VNTR) polymorphism in the 3’ untranslated region of the SLC6A3 gene in our European sample of 187 schizophrenia/schizoaffective disorder patients assessed for TD occurrence based on the Abnormal Involuntary Movement Scale (AIMS). We also explored the interaction between the VNTR and the TD-associated SLC18A2 marker rs363224. Results Our preliminary analysis did not show the SLC6A3 VNTR to be associated with TD occurrence or severity. There also appeared to be no significant interaction between SLC6A3 VNTR and SLC18A2 rs363224 in TD occurrence or severity (p>0.05). Discussion Our findings did not support a major role of the dopamine transporter gene in TD risk or severity, but we will examine additional putative functional markers in this gene.

  14. Association of tardive dyskinesia with variation in CYP2D6: Is there a role for active metabolites?

    PubMed Central

    Koola, Maju M; Tsapakis, Evangelia M; Wright, Padraig; Smith, Shubulade; Kerwin, Robert W(RIP); Nugent, Katie L; Aitchison, Katherine J

    2018-01-01

    Background The aim of this study was to examine whether there was an association between tardive dyskinesia (TD) and number of functional CYP2D6 genes. Methods A Caucasian sample of 70 patients was recruited in 1996–1997 from South London and Maudsley National Health Service (NHS) Foundation Trust, UK. Subjects had a DSM-IIIR diagnosis of schizophrenia and were treated with typical antipsychotics at doses equivalent to at least 100 mg chlorpromazine daily for at least 12 months prior to assessment. All patients were genotyped for CYP2D6 alleles*3–5, *41, and for amplifications of the gene. Results There were 13 patients with TD. The mean (standard deviation (SD)) years of duration of antipsychotic treatment in TD-positive was 15.8 (7.9) vs TD-negative 11.1 (7.4) (p=0.04). Increased odds of experiencing TD were associated with increased ability to metabolize CYP2D6, as measured by genotypic category (odds ratio (OR)=4.2), increasing duration in treatment (OR=1.0), and having drug-induced Parkinsonism (OR=9.7). Discussion We found a significant association between CYP2D6 genotypic category and TD with the direction of effect being an increase in the number of functional CYP2D6 genes being associated with an increased risk of TD. This is the first study to examine the association between TD and CYP2D6 in Caucasians with this number of genotypic categories. In the future, metabolomics may be utilized in the discovery of biomarkers and novel drug targets. PMID:24595968

  15. [52th Commemoration of French Journal of Plastic Aesthetic Surgery (1956-2007). Fifty-four years of editorial; five Editors-in-chief].

    PubMed

    Cariou, J-L

    2007-08-01

    The french Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) is born December 3th 1952. Initially without "aesthetic", this "key-word" is agreed in 1983 and the symbols are advanced since: SFCPR, SFCPRE, SOF.CPRE. Its official organ, formerly included in Annales de chirurgie (1954-1955), become Annales de chirurgie plastique in 1956, Annales de chirurgie plastique et esthétique in 1983 and finally Annales de chirurgie plastique esthétique (ACPE) in 1992. Since the origin, five Editors-in-chief succeded: Claude Dufourmentel, Raymond Vilain, Jean-Pierre Lalardrie, Claude Lê-Quang, Jean-Luc Cariou. Four of them are alive, Raymond Vilain is dead. The author relate here the natural story of these five editors who had all a triple route: personnal, surgical and editorial.

  16. Anti-leukaemic effects induced by APR-246 are dependent on induction of oxidative stress and the NFE2L2/HMOX1 axis that can be targeted by PI3K and mTOR inhibitors in acute myeloid leukaemia cells.

    PubMed

    Ali, Dina; Mohammad, Dara K; Mujahed, Huthayfa; Jonson-Videsäter, Kerstin; Nore, Beston; Paul, Christer; Lehmann, Sören

    2016-07-01

    The small molecule APR-246 (PRIMA-1(MET) ) is a novel drug that restores the activity of mutated and unfolded TP53 protein. However, the mechanisms of action and potential off-target effects are not fully understood. Gene expression profiling in TP53 mutant KMB3 acute myeloid leukaemia (AML) cells showed that genes which protected cells from oxidative stress to be the most up-regulated. APR-246 exposure also induced reactive oxygen species (ROS) formation and depleted glutathione in AML cells. The genes most up-regulated by APR-246, confirmed by quantitative real time polymerase chain reaction, were heme oxygenase-1 (HMOX1, also termed HO-1), SLC7A11 and RIT1. Up-regulation of HMOX1, a key regulator of cellular response to ROS, was independent of TP53 mutational status. NFE2L2 (also termed Nrf2), a master regulator of HMOX1 expression, showed transcriptional up-regulation and nuclear translocation by APR-246. Down-regulation of NFE2L2 by siRNA in AML cells significantly increased the antitumoural effects of APR-246. The PI3K inhibitor wortmannin and the mTOR inhibitor rapamycin inhibited APR-246-induced nuclear translocation of NFE2L2 and counteracted the protective cellular responses to APR-246, resulting in synergistic cell killing together with APR-246. In conclusion, ROS induction is important for antileukaemic activities of APR-246 and inhibiting the protective response of the Nrf-2/HMOX1 axis using PI3K inhibitors, enhances the antileukaemic effects. © 2016 John Wiley & Sons Ltd.

  17. 75 FR 44847 - Proposed Collection; Comment Request for Forms 943, 943-PR, 943-A, and 943A-PR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-29

    ... Para La Declarcion Anual De La Contribucion Federal Del Patrono De Empleados Agricolas, 943-A, Agricultural Employer's Record of Federal Tax Liability, and 943A-PR, Registro De La Obligacion Contributiva...: Employer's Annual Tax Return for Agricultural Employees (Form 943), Planilla Para La Declarcion Anual De La...

  18. 78 FR 47051 - Proposed Collection; Comment Request for Forms 943, 943-PR, 943-A, and 943A-PR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ..., 943-PR, Planilla Para La Declarcion Anual De La Contribucion Federal Del Patrono De Empleados Agricolas, 943-A, Agricultural Employer's Record of Federal Tax Liability, and 943A-PR, Registro De La...: Employer's Annual Tax Return for Agricultural Employees (Form 943), Planilla Para La Declarcion Anual De La...

  19. Treatment of Tardive Dyskinesia: A General Overview with Focus on the Vesicular Monoamine Transporter 2 Inhibitors.

    PubMed

    Niemann, Nicki; Jankovic, Joseph

    2018-04-01

    Tardive dyskinesia (TD) encompasses the spectrum of iatrogenic hyperkinetic movement disorders following exposure to dopamine receptor-blocking agents (DRBAs). Despite the advent of atypical or second- and third-generation antipsychotics with a presumably lower risk of complications, TD remains a persistent and challenging problem. Prevention is the first step in mitigating the risk of TD, but early recognition, gradual withdrawal of offending medications, and appropriate treatment are also critical. As TD is often a persistent and troublesome disorder, specific antidyskinetic therapies are often needed for symptomatic relief. The vesicular monoamine transporter 2 (VMAT2) inhibitors, which include tetrabenazine, deutetrabenazine, and valbenazine, are considered the treatment of choice for most patients with TD. Deutetrabenazine-a deuterated version of tetrabenazine-and valbenazine, the purified parent product of one of the main tetrabenazine metabolites, are novel VMAT2 inhibitors and the only drugs to receive approval from the US FDA for the treatment of TD. VMAT2 inhibitors deplete presynaptic dopamine and reduce involuntary movements in many hyperkinetic movement disorders, particularly TD, Huntington disease, and Tourette syndrome. The active metabolites of the VMAT2 inhibitors have high affinity for VMAT2 and minimal off-target binding. Compared with tetrabenazine, deutetrabenazine and valbenazine have pharmacokinetic advantages that translate into less frequent dosing and better tolerability. However, no head-to-head studies have compared the various VMAT2 inhibitors. One of the major advantages of VMAT2 inhibitors over DRBAs, which are still being used by some clinicians in the treatment of some hyperkinetic disorders, including TD, is that they are not associated with the development of TD. We also briefly discuss other treatment options for TD, including amantadine, clonazepam, Gingko biloba, zolpidem, botulinum toxin, and deep brain stimulation. Treatment

  20. MSBIS: A Multi-Step Biomedical Informatics Screening Approach for Identifying Medications that Mitigate the Risks of Metoclopramide-Induced Tardive Dyskinesia.

    PubMed

    Xu, Dong; Ham, Alexandrea G; Tivis, Rickey D; Caylor, Matthew L; Tao, Aoxiang; Flynn, Steve T; Economen, Peter J; Dang, Hung K; Johnson, Royal W; Culbertson, Vaughn L

    2017-12-01

    In 2009 the U.S. Food and Drug Administration (FDA) placed a black box warning on metoclopramide (MCP) due to the increased risks and prevalence of tardive dyskinesia (TD). In this study, we developed a multi-step biomedical informatics screening (MSBIS) approach leveraging publicly available bioactivity and drug safety data to identify concomitant drugs that mitigate the risks of MCP-induced TD. MSBIS includes (1) TargetSearch (http://dxulab.org/software) bioinformatics scoring for drug anticholinergic activity using CHEMBL bioactivity data; (2) unadjusted odds ratio (UOR) scoring for indications of TD-mitigating effects using the FDA Adverse Event Reporting System (FAERS); (3) adjusted odds ratio (AOR) re-scoring by removing the effect of cofounding factors (age, gender, reporting year); (4) logistic regression (LR) coefficient scoring for confirming the best TD-mitigating drug candidates. Drugs with increasing TD protective potential and statistical significance were obtained at each screening step. Fentanyl is identified as the most promising drug against MCP-induced TD (coefficient: -2.68; p-value<0.01). The discovery is supported by clinical reports that patients fully recovered from MCP-induced TD after fentanyl-induced general anesthesia. Loperamide is identified as a potent mitigating drug against a broader range of drug-induced movement disorders through pharmacokinetic modifications. Using drug-induced TD as an example, we demonstrated that MSBIS is an efficient in silico tool for unknown drug-drug interaction detection, drug repurposing, and combination therapy design. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Switching antipsychotic treatment to aripiprazole in psychotic patients with neuroleptic-induced tardive dyskinesia: a 24-week follow-up study.

    PubMed

    Chan, Chia-Hsiang; Chan, Hung-Yu; Chen, Yen-Ching

    2018-05-01

    Aripiprazole is a second-generation antipsychotics, acting as a partial dopamine D2 receptor agonist. Previous studies on aripiprazole for tardive dyskinesia (TD) treatment were limited and inconclusive. This study was aimed to examine the effectiveness of aripiprazole in psychotic patients with a pre-existing TD. This was an open-label 24-week prospective cohort study conducted in a public mental hospital in Northern Taiwan from January 2009 to February 2010. Psychotic patients were cross-titrated of prior antipsychotics with aripiprazole, and the severity of TD was assessed at baseline and at weeks 2, 4, 8, 12, 16, 20, and 24. The primary study outcome was the change of TD severity, assessed by Abnormal Involuntary Movement Scale (AIMS) total score. Responder was defined as the reduction of AIMS total scores of no less than 50% from baseline to the study endpoint (24 weeks). Thirty psychotic patients with neuroleptic-induced TD were recruited. The AIMS total scores significantly decreased from baseline to the study endpoint (-7.17±5.55). The significant decrease of AIMS total scores started at week 2 (P<0.0001), and the change remained significant throughout the entire study period (P<0.0001). A greater severity of TD (adjusted odds ratio: 1.35, 95% confidence interval: 1.04-1.76, P=0.03) or a lower severity of parkinsonism (adjusted odds ratio: 0.78, 95% confidence interval: 0.61-0.99, P=0.04) at baseline was significantly associated with treatment responders. Our findings implicated that aripiprazole can be a promising treatment for clinicians considering drug switch in psychotic patients with TD. Further large randomized, controlled trials are warranted to confirm our findings.

  2. A combination of p53-activating APR-246 and phosphatidylserine-targeting antibody potently inhibits tumor development in hormone-dependent mutant p53-expressing breast cancer xenografts

    PubMed Central

    Liang, Yayun; Mafuvadze, Benford; Besch-Williford, Cynthia; Hyder, Salman M

    2018-01-01

    Background Between 30 and 40% of human breast cancers express a defective tumor suppressor p53 gene. Wild-type p53 tumor suppressor protein promotes cell-cycle arrest and apoptosis and inhibits vascular endothelial growth factor–dependent angiogenesis, whereas mutant p53 protein (mtp53) lacks these functions, resulting in tumor cell survival and metastasis. Restoration of p53 function is therefore a promising drug-targeted strategy for combating mtp53-expressing breast cancer. Methods In this study, we sought to determine whether administration of APR-246, a small-molecule drug that restores p53 function, in combination with 2aG4, an antibody that targets phosphatidylserine residues on tumor blood vessels and disrupts tumor vasculature, effectively inhibits advanced hormone-dependent breast cancer tumor growth. Results APR-246 reduced cell viability in mtp53-expressing BT-474 and T47-D human breast cancer cells in vitro, and significantly induced apoptosis in a dose-dependent manner. However, APR-246 did not reduce cell viability in MCF-7 breast cancer cells, which express wild-type p53. We next examined APR-246’s anti-tumor effects in vivo using BT-474 and T47-D tumor xenografts established in female nude mice. Tumor-bearing mice were treated with APR-246 and/or 2aG4 and tumor volume followed over time. Tumor growth was more effectively suppressed by combination treatment than by either agent alone, and combination therapy completely eradicated some tumors. Immunohistochemistry analysis of tumor tissue sections demonstrated that combination therapy more effectively induced apoptosis and reduced cell proliferation in tumor xenografts than either agent alone. Importantly, combination therapy dramatically reduced the density of blood vessels, which serve as the major route for tumor metastasis, in tumor xenografts compared with either agent alone. Conclusion Based on our findings, we contend that breast tumor growth might effectively be controlled by simultaneous

  3. Le don après un décès d'origine cardiocirculatoire au Canada

    PubMed Central

    Shemie, Sam D.; Baker, Andrew J.; Knoll, Greg; Wall, William; Rocker, Graeme; Howes, Daniel; Davidson, Janet; Pagliarello, Joe; Chambers-Evans, Jane; Cockfield, Sandra; Farrell, Catherine; Glannon, Walter; Gourlay, William; Grant, David; Langevin, Stéphan; Wheelock, Brian; Young, Kimberly; Dossetor, John

    2006-01-01

    Résumé Ces recommandations sont le fruit d'un processus multidisciplinaire national ayant duré un an et visant à déterminer si et comment l'on pourrait procéder au don d'organes après un décès d'origine cardiocirculatoire («don après le décès cardiocirculatoire», ou DDC) au Canada. Le forum national organisé en février 2005 a permis aux participants de discuter et d'élaborer des recommandations sur les principes, interventions et pratiques se rapportant au DDC. Les aspects éthiques et juridiques ont été abordés dans les discussions. À la fin du Forum, la majorité des participants ont été favorables à l'implantation de programmes de DDC au Canada. Les participants du Forum ont également convenu qu'il fallait formuler et prôner des valeurs fondamentales pour orienter l'élaboration de programmes et de protocoles basés sur le cadre médical, éthique et juridique établi lors de cette réunion. Même si la possibilité d'un don d'organes et de tissus doit faire partie intégrante des soins de fin de vie, il faut insister sur le fait que le devoir de diligence envers les patients mourants et leurs familles doit demeurer la priorité des équipes soignantes. La complexité et les répercussions profondes du décès sont reconnues et doivent être respectées, de même que les différences personnelles, ethnoculturelles et religieuses face à la mort et au don d'organes. Les décisions d'arrêter le traitement de maintien des fonctions vitales, la prise en charge des derniers moments de la vie et le diagnostic de décès selon des critères cardiocirculatoires doivent être distincts et indépendants des processus de don et transplantation. Ce rapport contient des recommandations destinées aux gestionnaires de program, aux autorités sanitaires régionales et aux instances appelés à élaborer les protocoles de DDC. Les programmes doivent être conçus en fonction des éléments suivants : direction et planification locales, éducation et

  4. 78 FR 14155 - Special Conditions: Learjet Inc., Model LJ-200-1A10 Airplane; Use of Automatic Power Reserve (APR...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... Automatic Power Reserve (APR), an Automatic Takeoff Thrust Control System (ATTCS), for Go-Around Performance... airplane will have novel or unusual design features associated with utilizing go-around performance credit...: Federal eRegulations Portal: Go to http://www.regulations.gov/ and follow the online instructions for...

  5. Les Cicatrices Retractiles Post-Brulures Du Membre Inferieur Chez L’Enfant

    PubMed Central

    Sankale, A.A.; Manyacka Ma Nyemb, P.; Coulibaly, N.F.; Ndiaye, A.; Ndoye, M.

    2010-01-01

    Summary Il s'agit d'une étude faisant ressortir les aspects épidémiologiques, cliniques et thérapeutiques des séquelles de brûlures du membre inférieur chez l'enfant, à propos de 42 cas colligés au service de chirurgie infantile de l'Hôpital Aristide Le Dantec (Sénégal). L'âge moyen retrouvé est de 5 ans et 3 mois, et le sex-ratio garçons/filles de 1,8/1. La brûlure thermique est causée par une flamme dans 33% des cas, par un liquide chaud dans 21% des cas, et par des braises dans 21% des cas. Les cicatrices rétractiles intéressent le genou et le creux poplité dans 47% des cas et le pied dans 45% des cas. Elles sont bilatérales dans 21% des cas, et concernent une autre localisation associée dans 21% des cas. Quant aux brides, 21% ont bénéficié d'une chirurgie, avec un délai moyen de 3 ans et 2 mois après la brûlure. Cette procédure chirurgicale consiste en une plastie en Z dans 91% des cas, à laquelle est associée une greffe de peau dans 54% des cas. Une rééducation fonctionnelle est pratiquée chez 54% des opérés. Parallèlement aux données de la littérature, nos résultats montrent que l'optimisation de la prise en charge passe par une meilleure prévention des accidents domestiques et une bonne codification thérapeutique. PMID:21991202

  6. Mimicking acute and chronic stress exposure in naive beef steers alters the acute phase response (APR) associated with vaccination

    USDA-ARS?s Scientific Manuscript database

    This study was designed to determine the effect of an acute versus chronic stress model on the APR associated with vaccination in naïve beef steers. Steers (n=32; 209 +/- 8 kg) were blocked by body weight and assigned to 1 of 3 treatments: 1) Chronic stress (CHR), 0.5 mg/kg body weight dexamethasone...

  7. Use case driven approach to develop simulation model for PCS of APR1400 simulator

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

    Dong Wook, Kim; Hong Soo, Kim; Hyeon Tae, Kang

    2006-07-01

    The full-scope simulator is being developed to evaluate specific design feature and to support the iterative design and validation in the Man-Machine Interface System (MMIS) design of Advanced Power Reactor (APR) 1400. The simulator consists of process model, control logic model, and MMI for the APR1400 as well as the Power Control System (PCS). In this paper, a use case driven approach is proposed to develop a simulation model for PCS. In this approach, a system is considered from the point of view of its users. User's view of the system is based on interactions with the system and themore » resultant responses. In use case driven approach, we initially consider the system as a black box and look at its interactions with the users. From these interactions, use cases of the system are identified. Then the system is modeled using these use cases as functions. Lower levels expand the functionalities of each of these use cases. Hence, starting from the topmost level view of the system, we proceeded down to the lowest level (the internal view of the system). The model of the system thus developed is use case driven. This paper will introduce the functionality of the PCS simulation model, including a requirement analysis based on use case and the validation result of development of PCS model. The PCS simulation model using use case will be first used during the full-scope simulator development for nuclear power plant and will be supplied to Shin-Kori 3 and 4 plant. The use case based simulation model development can be useful for the design and implementation of simulation models. (authors)« less

  8. Appraisal of the Psychiatric Diagnostic Screening Questionnaire in a perinatal cohort: The APrON study.

    PubMed

    Leung, Brenda; Letourneau, Nicole; Bright, Katherine; Giesbrecht, Gerald F; Ntanda, Henry; Gagnon, Lisa

    2017-08-01

    Depression and anxiety are routinely screened as part of perinatal care. However, other Axis 1 disorders and specific anxiety disorders are less likely to be screened or assessed as part of obstetric care. The objective of this study was to determine whether the Psychiatric Diagnostic Screening Questionnaire (PDSQ) is a potentially useful tool to screen for psychiatric conditions in pregnant and postpartum women in a community setting. We compared the prevalence of DSM Axis I disorders obtained on the PDSQ with: (1) the prevalence of these disorders reported in previous studies of pregnant and postpartum women, and (2) scores obtained on the Edinburgh Postpartum Depression Scale (EPDS) and the Symptom Checklist-90-Revised (SCL-90R) anxiety scale. Data were obtained from the Alberta Pregnancy Outcomes and Nutrition (APrON) study. The PDSQ was completed by 1575 women prenatally and 1481 postnatally. The three most prevalent PDSQ conditions were social phobia, somatic disorder, and obsessive-compulsive disorder (OCD). The prevalence of social phobia, alcohol disorder, OCD and psychosis were higher in the APrON cohort compared with statistics in the literature. The proportion of women meeting depression and anxiety cut-offs on the PDSQ were lower than for the EPDS and the SCL-90R. The Cohens Kappa index ( k) indicated poor to fair agreement between the measures in classifying pregnant women as depressed or anxious. The PDSQ subscales may not be appropriate for the pregnant population. Research into instruments more specific to pregnant and postpartum women are needed to determine the prevalence of psychiatric disorders in this population.

  9. Kyste hydatique mammaire primitive

    PubMed Central

    Boufettal, Houssine; Samouh, Naïma

    2015-01-01

    La localisation mammaire du kyste hydatique est exceptionnelle. De ce fait, le diagnostic est difficile avant l'examen anatomopathologique. Nous rapportons une observation d'un cas de kyste hydatique du sein chez une femme de 32 ans, qui consultait pour un nodule du sein, dont l'imagerie montrait une lésion en rétro-aréolaire du sein gauche, homogène, ovalaire et de contours réguliers. L'examen anatomopathologique objectivait un kyste hydatique à localisation mammaire. Les suites opératoires étaient simples. L'hydatidose est une maladie ubiquitaire, pouvant atteindre tous les organes. Le diagnostic peut être évoqué devant une masse kystique du sein avec des aspects très évocateurs à l'imagerie. La confirmation du diagnostic n'est confirmée qu'après une cytoponction ou une chirurgie d'exérèse qui réalise le traitement de cette pathologique. La négativité du bilan d'extension hydatique permet de retenir une localisation primitive de l’échinococcose. PMID:26185575

  10. [Tardive dyskinesia induced by classical antipsychotic drugs: a Tunisian sample of schizophrenics].

    PubMed

    Sejil, I; Oumaya, A; Bouguerra, C; Mehdi, F; Bellaaj, R; Gallali, S

    2013-05-01

    The term tardive dyskinesia (TD) is used to describe abnormal movement, primarily associated with typical antipsychotic drugs, which are used to treat psychotic states such as schizophrenia. TD is characterised by repetitive involuntary purposeless muscle contractions that force parts of the body into abnormal, and sometimes painful, movements or postures. These movements are involuntary and are difficult or impossible to control. TD usually begins with the face, mouth, lips and tongue, and includes grimacing, lip-smacking, tongue movements and rapid blinking. It may also involve the rest of the body and produce involuntary gestures, tics and writhing movements. TD is severe physically and socially disabling. Schizophrenia is thought to be the psychiatric diagnosis the most frequently associated with TD. The purpose of this article is to study the characteristics of TD in a Tunisian sample of 157 schizophrenics. A variety of demographic and clinical information was obtained by a questionnaire. Diagnoses of schizophrenia and TD were determined by using DSM-VI-R criteria. TD was assessed using the Abnormal Involuntary Movements Scale (AIMS). The average age in this sample was 37 ± 6 years. The intermediate duration of evolution of the disease was 8 ± 3 years with a medium full number of hospitalizations of 4 ± 3. We found 58% of the paranoid sub-type. The intermediate duration of exposure to classical neuroleptics was 7 ± 3 years. The average of daily neuroleptic amount was 572.9 ± 145.3 equivalent milligrams of chlorpromazine. Extended release antipsychotics were used in 64.3% of cases, with fluphenazine deaconate in 90% and haloperidol deaconate in 10%. Anticholinergics were used by 74.5% of patients, with use of biperidene in 96% of cases. Therapeutic observance was good in 89.2% of patients. The prevalence of TD was an estimated 35%. The average of AIMS score was 17 ± 9, with a minimal score of 3 and a maximal one of 34. The distribution of patients

  11. 15 CFR 781.4 - U.S. Government requests for information needed to satisfy the requirements of the APR or the Act.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false U.S. Government requests for information needed to satisfy the requirements of the APR or the Act. 781.4 Section 781.4 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY...

  12. Determining Whether a Definitive Causal Relationship Exists Between Aripiprazole and Tardive Dyskinesia and/or Dystonia in Patients With Major Depressive Disorder, Part 2: Preclinical and Early Phase Human Proof of Concept Studies.

    PubMed

    Macaluso, Matthew; Flynn, Alexandra; Preskorn, Sheldon

    2016-01-01

    This series of columns has 3 main goals: (1) to explain class warnings as used by the United States Food and Drug Administration, (2) to increase awareness of movement disorders that may occur in patients treated with antipsychotic medications, and (3) to understand why clinicians should refrain from immediately assuming a diagnosis of tardive dyskinesia/dystonia (TD) in patients treated with antipsychotics. The first column in this series began with the case of a 76-year-old man with major depressive disorder who developed orofacial dyskinesias while being treated with aripiprazole as an antidepressant augmentation strategy. It was alleged that a higher than intended dose of aripiprazole (ie, 20 mg/d for 2 wk followed by 10 mg/d for 4 wk instead of the intended dose of 2 mg/d) was the cause of the dyskinetic movements in this man, and the authors were asked to review the case and give their opinion. The principal basis for this theory of causation was the class warning about TD in the package insert for aripiprazole. The rationale for concluding aripiprazole caused TD in the 76-year-old man led to this series of columns about aripiprazole, its potential--if any--to cause TD, and the presence of a class warning about TD in its package insert. The central point is to illustrate why class warnings exist and their implications for practice. The first column in this series focused on the historical background, incidence, prevalence, risk factors, and clinical presentations of tardive and spontaneous dyskinesias and concluded with a discussion of diagnostic considerations explaining why clinicians should avoid making a diagnosis of TD until a thorough differential diagnosis has been considered. This second column in the series reviews the pharmacology of aripiprazole and the preclinical and phase I translational human studies that suggest aripiprazole should have a low to nonexistent risk of causing TD compared with other antipsychotics. The third column in the series

  13. Gamma-aminobutyric acid agonists for antipsychotic-induced tardive dyskinesia.

    PubMed

    Alabed, Samer; Latifeh, Youssef; Mohammad, Husam Aldeen; Bergman, Hanna

    2018-04-17

    Chronic antipsychotic drug treatment may cause tardive dyskinesia (TD), a long-term movement disorder. Gamma-aminobutyric acid (GABA) agonist drugs, which have intense sedative properties and may exacerbate psychotic symptoms, have been used to treat TD. 1. Primary objectiveThe primary objective was to determine whether using non-benzodiazepine GABA agonist drugs for at least six weeks was clinically effective for the treatment of antipsychotic-induced TD in people with schizophrenia, schizoaffective disorder or other chronic mental illnesses.2. Secondary objectivesThe secondary objectives were as follows.To examine whether any improvement occurred with short periods of intervention (less than six weeks) and, if this did occur, whether this effect was maintained at longer periods of follow-up.To examine whether there was a differential effect between the various compounds.To test the hypothesis that GABA agonist drugs are most effective for a younger age group (less than 40 years old). We searched the Cochrane Schizophrenia Group Trials Register (last searched April 2017), inspected references of all identified studies for further trials, and, when necessary, contacted authors of trials for additional information. We included randomised controlled trials of non-benzodiazepine GABA agonist drugs in people with antipsychotic-induced TD and schizophrenia or other chronic mental illness. Two review authors independently selected and critically appraised studies, extracted and analysed data on an intention-to-treat basis. Where possible and appropriate we calculated risk ratios (RRs) and their 95% confidence intervals (CIs). For continuous data we calculated mean differences (MD). We assumed that people who left early had no improvement. We contacted investigators to obtain missing information. We assessed risk of bias for included studies and created a 'Summary of findings' table using GRADE. We included 11 studies that randomised 343 people. Overall, the risk of bias

  14. Synthesis of Key Points from the OSEP Early Childhood Transition FAQ (SPP/APR Indicators C-8, B-11 and B-12)

    ERIC Educational Resources Information Center

    Diefendorf, M.; Henson, J.; Lucas, A.; Whaley, K.

    2010-01-01

    This document is a synthesis of the key points provided in the Office of Special Education Programs (OSEP) Early Childhood Transition FAQs: SPP/APR indicators C-8 and B-12 released on December 1, 2009. It was developed to assist states with the implementation of effective transition policies and practices. The following is included: (1) Transition…

  15. Determining Whether a Definitive Causal Relationship Exists Between Aripiprazole and Tardive Dyskinesia and/or Dystonia in Patients With Major Depressive Disorder, Part 4: Case Report Data.

    PubMed

    Macaluso, Matthew; Flynn, Alexandra; Preskorn, Sheldon

    2016-05-01

    This series of columns has 3 main goals: (1) to explain class warnings as used by the United States Food and Drug Administration, (2) to increase awareness of movement disorders that may occur in patients treated with antipsychotic medications, and (3) to understand why clinicians should refrain from immediately assuming a diagnosis of tardive dyskinesia/dystonia (TD) in patients who develop abnormal movements during treatment with antipsychotics. The first column in the series presented a patient who developed abnormal movements while being treated with aripiprazole as an augmentation strategy for major depressive disorder and reviewed data concerning the historical background, incidence, prevalence, and risk factors for tardive and spontaneous dyskinesias, the clinical presentations of which closely resemble each other. The second column in the series reviewed the unique mechanism of action of aripiprazole and reviewed preclinical studies and an early-phase human translational study that suggest a low, if not absent, risk of TD with aripiprazole. The third column in this series reviewed the registration trial data for aripiprazole across all of its indications and found a raw incidence of TD ranging from 0.004 (4 out of 987) in long-term studies of the drug as an augmentation strategy for major depressive disorder to 0.0016 (19 out of 11,897) based on all short-term (ie, weeks to <6 mo) and long-term (6 mo to 1 y) studies combined. This fourth column in the series reviews the "real-world" data on aripiprazole and assesses whether these data also support the conclusion that aripiprazole has a low to absent risk of causing TD. The "real-world" data consist of case reports from the medical literature and the United States Food and Drug Administration Adverse Event Reporting System (FAERS). We found 37 cases in the medical literature reporting what was termed TD in association with aripiprazole treatment as well as 27 case reports suggesting improvement in

  16. Resting-state Brain Activity Changes Associated with Tardive Dyskinesia in Patients with Schizophrenia: Fractional Amplitude of Low-frequency Fluctuation Decreased in the Occipital Lobe.

    PubMed

    Zhang, Ping; Li, Yanli; Fan, Fengmei; Li, Chiang-Shan R; Luo, Xingguang; Yang, Fude; Yao, Yin; Tan, Yunlong

    2018-06-19

    We explored resting-state brain activity and its potential links to clinical parameters in schizophrenic patients with tardive dyskinesia (TD) using fractional amplitude of low-frequency fluctuations (fALFF). Resting-state functional magnetic resonance imaging data were acquired from 32 schizophrenic patients with TD (TD group), 31 without TD (NTD group), and 32 healthy controls (HC group). Clinical parameters including psychopathological symptoms, severity of TD, and cognitive function were assessed using the Positive and Negative Syndrome Scale, Abnormal Involuntary Movement Scale (AIMS), and Repeatable Battery for the Assessment of Neuropsychological Status, respectively. Pearson correlation analyses were performed to determine the relationship between the regions with altered fALFF values and clinical parameters in TD patients. The TD group showed decreased fALFF in the left middle occipital gyrus (MOG) and the right calcarine sulcus (CAL) compared to the HC group, and decreased fALFF in the left cuneus compared to the NTD group. In the TD group, fALFF values in the left MOG and the right CAL were correlated separately with the delayed memory score (r = 0.44, p = 0.027; r = 0.43, p = 0.028, respectively). The AIMS total score was negatively correlated to the visuospatial/constructional score (r = -0.53, p = 0.005). Our findings suggested that resting-state brain activity changes were associated with TD in schizophrenic patients. There was an association between the decreased brain activity in the occipital lobe and the delayed memory cognition impairment in this population. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

  17. Chirurgie angeborener Herzfehler

    NASA Astrophysics Data System (ADS)

    Schreiber, Christian; Libera, Paul; Lange, Rüdiger

    Störungen der embryonalen Entwicklung in der frühen Phase der Schwangerschaft können zu Fehlbildungen am Herz- und Gefäßsystem führen. Die Häufigkeit liegt bei 0.8-1 % aller lebend geborenen Kinder. In Deutschland werden jedes Jahr etwa 6.000 Kinder mit einem Herzfehler geboren (Quelle: http://www.kompetenznetzahf.de). Das Spektrum reicht von einfachen Fehlern, die das Herz-Kreislauf-System wenig beeinträchtigen, bis zu sehr schweren Herzerkrankungen, die unbehandelt zum Tode führen. Fortschritte der Kinderkardiologie, Herzchirurgie und Anästhesie ermöglichen heute ein Überleben bei über 90 % der Patienten. Auch die spezialisierte Pränataldiagnostik (vorgeburtliche Diagnostik) ermöglicht schon die frühe Weichenstellung für mögliche Therapieoptionen. Bei der chirurgischen Therapie ist jedoch festzuhalten, dass ein Herzfehler entweder korrigierend behandelt wird oder nur "palliiert“ werden kann. Bei letzterer Therapie wird bei einem Patienten eine medizinische Maßnahme durchgeführt, die nicht die Herstellung normaler Körperfunktionen zum Ziel hat, sondern in Anpassung an die physiologischen Besonderheiten des Patienten dessen Zustand lediglich stabilisiert und optimiert. Dies kann beispielsweise bei einer nicht korrigierbaren angeborenen Fehlbildung notwendig sein, bei der lediglich eine funktionelle Herzkammer vorhanden ist (z. B. hypoplastisches Linksherz). Hierbei muss eine prothetische Verbindung zur Lungenstrombahn in der Folgezeit entfernt werden.

  18. La pubalgie du sportif: mise au point à propos d'une étude rétrospective de 128 joueurs

    PubMed Central

    Mahmoudi, Ammar; Frioui, Samia; Jemni, Sonia; Khachnaoui, Faycel; Dahmene, Younes

    2015-01-01

    La pubalgie du sportif de haut niveau représente une entité nosologique à part entière, tant en raison du mécanisme à l'origine de la pathologie que des lésions objectivables au niveau de la paroi abdominale. C'est un syndrome douloureux de la région inguino-pubienne qui touche particulièrement les footballeurs. Son étiologie est attribuée à la répétition de mouvements des membres inférieurs et du tronc associant rotation et adduction forcées. Son incidence est nettement plus élevée chez les hommes. Après avoir écarté une pathologie d'organe, le patient devrait bénéficier tout au début de son traitement conservateur d'une IRM afin d'effectuer un bilan lésionnel complet qui, selon les situations, permet d’écourter le traitement conservateur et de proposer un traitement chirurgical optimal. Le traitement doit être résolument conservateur pendant 3 mois. La rééducation est le plus souvent le traitement de première intention. Les patients présentant une persistance des symptômes sont candidats à la chirurgie. L'intervention de Nesovic est le traitement de choix chez les sportifs de haut niveau et qui permet, dans la très grande majorité des cas, une reprise sans aucune limitation de l'activité sportive antérieure. La technique de Bassini semble être moins lourde que celle de Nesovic, puisqu'elle est moins invasive. Une prise en charge multidisciplinaire centrée sur l'athlète avant et après l'intervention permet un retour aux activités physiques après quelques mois. Nous rapportons l'expérience de la prise en charge de 128 joueurs opérés selon la technique de Bassini et nous comparons nos résultats avec celles de la littérature. PMID:26966484

  19. Variability of nursing care by APR-DRG and by severity of illness in a sample of nine Belgian hospitals.

    PubMed

    Pirson, Magali; Delo, Caroline; Di Pierdomenico, Lionel; Laport, Nancy; Biloque, Veronique; Leclercq, Pol

    2013-10-10

    As soon as Diagnosis related Groups (DRG) were introduced in many hospital financing systems, most nursing research revealed that DRG were not very homogeneous with regard to nursing care. However, few studies are based on All Patient refined Diagnosis related Groups (APR-DRGs) and few of them use recent data. Objectives of this study are: (1) to evaluate if nursing activity is homogeneous by APR-DRG and by severity of illness (SOI) (2) to evaluate the outlier's rate associated with the nursing activity and (3) to compare nursing cost homogeneity per DRG and SOI. Study done in 9 Belgian hospitals on a selection of APR-DRG with more than 30 patients (7 638 inpatient stays). The evaluation of the homogeneity is based on coefficients of variation (CV). The 75th percentile + 1.5 × inter-quartile range was used to select high outliers. 25th percentile -1.5 × inter-quartile range was used to select low outliers. Nursing costs per ward were distributed on inpatient stays of each ward following two techniques (the LOS vs. the number of nursing care minutes per stay). The homogeneity of LOS by DRG and by SOI is relatively good (CV: 0.56). The homogeneity of the nursing activity by DRG is less good (CVs between 0.36 and 1.54) and is influenced by nursing activity outliers (high outliers' rate: 5.19%, low outliers' rate: 0.14%). The outlier's rate varies according to the studied variable. The high outliers' rate is higher for nursing activity than for LOS. The homogeneity of nursing costs is higher when costs are based on the LOS of patients than when based on minutes of nursing care (CVs between 0.26 and 1.46 for nursing costs based on LOS and between 0.49 and 2.04 for nursing costs based on minutes of nursing care). It is essential that the calculation of nursing cost by stay and by DRG for hospital financing purposes was based on nursing activity data, that more reflect resources used in wards, and not on LOS data. The only way to obtain this information is

  20. Variability of nursing care by APR-DRG and by severity of illness in a sample of nine Belgian hospitals

    PubMed Central

    2013-01-01

    Background As soon as Diagnosis related Groups (DRG) were introduced in many hospital financing systems, most nursing research revealed that DRG were not very homogeneous with regard to nursing care. However, few studies are based on All Patient refined Diagnosis related Groups (APR-DRGs) and few of them use recent data. Objectives of this study are: (1) to evaluate if nursing activity is homogeneous by APR-DRG and by severity of illness (SOI) (2) to evaluate the outlier’s rate associated with the nursing activity and (3) to compare nursing cost homogeneity per DRG and SOI. Methods Study done in 9 Belgian hospitals on a selection of APR-DRG with more than 30 patients (7 638 inpatient stays). The evaluation of the homogeneity is based on coefficients of variation (CV). The 75th percentile + 1.5 × inter-quartile range was used to select high outliers. 25th percentile −1.5 × inter-quartile range was used to select low outliers. Nursing costs per ward were distributed on inpatient stays of each ward following two techniques (the LOS vs. the number of nursing care minutes per stay). Results The homogeneity of LOS by DRG and by SOI is relatively good (CV: 0.56). The homogeneity of the nursing activity by DRG is less good (CVs between 0.36 and 1.54) and is influenced by nursing activity outliers (high outliers’ rate: 5.19%, low outliers’ rate: 0.14%). The outlier’s rate varies according to the studied variable. The high outliers’ rate is higher for nursing activity than for LOS. The homogeneity of nursing costs is higher when costs are based on the LOS of patients than when based on minutes of nursing care (CVs between 0.26 and 1.46 for nursing costs based on LOS and between 0.49 and 2.04 for nursing costs based on minutes of nursing care). Conclusions It is essential that the calculation of nursing cost by stay and by DRG for hospital financing purposes was based on nursing activity data, that more reflect resources used in wards, and not on LOS

  1. La Greffe de Peau dans le Traitement des Sequelles de la Main Brulee. A Propos de 152 Cas - Experience du Service de Chirurgie Plastique du Centre Hospitalier Universitaire Ibn-Sina, Rabat, Maroc

    PubMed Central

    El Mazouz, S.; Fejjal, N.; Hafidi, J.; Cherkab, L.; Mejjati, H.; Belfqih, R.; Gharib, N.; Abbassi, A.

    2010-01-01

    Summary La main est fréquemment exposée aux brûlures, entraînant des séquelles esthétiques et fonctionnelles. Le traitement de ces séquelles est surtout chirurgical et consiste en la greffe de peau, dont le type dépend de la localisation de la brûlure et du type des séquelles. Dans ce travail rétrospectif, nous rapportons une série de 152 cas de brûlures des mains colligés au service de chirurgie plastique du Centre Hospitalier Universitaire Ibn-Sina de Rabat sur une période de dix ans, allant de 1998 à 2007. Les indications thérapeutiques dépendent du type de séquelles et de la localisation de la brûlure. En tout, 97 patients ont bénéficié d'une greffe cutanée, dont 76% par greffe de peau totale, 21% par greffe de peau demi-épaisse et 3% par peau fine. Les séquelles des brûlures des mains posent un problème thérapeutique majeur, malgré la diversité des procédés chirurgicaux, d'où l'intérêt de la prévention. PMID:21991196

  2. Response Time Analysis and Test of Protection System Instrument Channels for APR1400 and OPR1000

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

    Lee, Chang Jae; Han, Seung; Yun, Jae Hee

    2015-07-01

    Safety limits are required to maintain the integrity of physical barriers designed to prevent the uncontrolled release of radioactive materials in nuclear power plants. The safety analysis establishes two critical constraints that include an analytical limit in terms of a measured or calculated variable, and a specific time after the analytical limit is reached to begin protective action. Keeping with the nuclear regulations and industry standards, satisfying these two requirements will ensure that the safety limit will not be exceeded during the design basis event, either an anticipated operational occurrence or a postulated accident. Various studies on the setpoint determinationmore » methodology for the safety-related instrumentation have been actively performed to ensure that the requirement of the analytical limit is satisfied. In particular, the protection setpoint methodology for the advanced power reactor 1400 (APP1400) and the optimized power reactor 1000 (OPR1000) has been recently developed to cover both the design basis event and the beyond design basis event. The developed setpoint methodology has also been quantitatively validated using specific computer programs and setpoint calculations. However, the safety of nuclear power plants cannot be fully guaranteed by satisfying the requirement of the analytical limit. In spite of the response time verification requirements of nuclear regulations and industry standards, it is hard to find the studies on the systematically integrated methodology regarding the response time evaluation. In cases of APR1400 and OPR1000, the response time analysis for the plant protection system is partially included in the setpoint calculation and the response time test is separately performed via the specific plant procedure. The test technique has a drawback which is the difficulty to demonstrate completeness of timing test. The analysis technique has also a demerit of resulting in extreme times that not actually possible

  3. Determining Whether a Definitive Causal Relationship Exists Between Aripiprazole and Tardive Dyskinesia and/or Dystonia in Patients With Major Depressive Disorder, Part 3: Clinical Trial Data.

    PubMed

    Preskorn, Sheldon H; Macaluso, Matthew

    2016-03-01

    This series of columns has 3 main goals: (1) to explain class warnings as used by the United States Food and Drug Administration, (2) to increase awareness of movement disorders that may occur in patients treated with antipsychotic medications, and (3) to understand why clinicians should refrain from immediately assuming a diagnosis of tardive dyskinesia/dystonia (TD) in patients who develop abnormal movements during treatment with antipsychotics. The first column in the series presented a patient who developed abnormal movements while being treated with aripiprazole as an augmentation strategy for major depressive disorder (MDD) and reviewed data concerning the historical background, incidence, prevalence, and risk factors for tardive and spontaneous dyskinesias, the clinical presentations of which closely resemble each other. The second column in the series reviewed the unique mechanism of action of aripiprazole and preclinical studies and an early-phase human translational study that suggest a low, if not absent, risk of TD with aripiprazole. This column reviews clinical trial data to assess whether those data support the conclusion that aripiprazole has a low to absent risk of causing TD when used as an augmentation strategy to treat MDD. To date, no randomized, placebo-controlled trials have established a definitive link between exposure to aripiprazole and TD in patients with MDD. One long-term, open-label, safety trial examined aripiprazole as an augmentation strategy in individuals with MDD and found a rare occurrence (4/987, 0.4%, the confidence interval of which overlaps with zero) of an adverse event termed TD. In all 4 cases, the observed movements resolved within weeks of aripiprazole discontinuation, suggesting that they were either amenable to treatment or represented an acute syndrome rather than TD. No cases of TD were reported in the registration trials for the MDD indication for aripiprazole. These data were presented in a pooled analysis of

  4. Analysis and improvements of Adaptive Particle Refinement (APR) through CPU time, accuracy and robustness considerations

    NASA Astrophysics Data System (ADS)

    Chiron, L.; Oger, G.; de Leffe, M.; Le Touzé, D.

    2018-02-01

    While smoothed-particle hydrodynamics (SPH) simulations are usually performed using uniform particle distributions, local particle refinement techniques have been developed to concentrate fine spatial resolutions in identified areas of interest. Although the formalism of this method is relatively easy to implement, its robustness at coarse/fine interfaces can be problematic. Analysis performed in [16] shows that the radius of refined particles should be greater than half the radius of unrefined particles to ensure robustness. In this article, the basics of an Adaptive Particle Refinement (APR) technique, inspired by AMR in mesh-based methods, are presented. This approach ensures robustness with alleviated constraints. Simulations applying the new formalism proposed achieve accuracy comparable to fully refined spatial resolutions, together with robustness, low CPU times and maintained parallel efficiency.

  5. La plaie cranio-cérébrale chez l'oxycéphale: quelle précaution prendre pour le traiter?

    PubMed Central

    Rifi, Loubna; Barkat, Amina; El Ouahabi, Abdessamad

    2015-01-01

    L'oxycéphalie isolée est une forme non syndromique des craniosténoses d'apparition tardive, elle est responsable d'hypertension intracrânienne insidieuse pouvant aboutir, sinon traitée précocement, à la cécité et à la débilité mentale. En général méconnue, elle peut être révélée par tout phénomène pouvant décompenser l'hypertension intracrânienne latente. Nous présentons un cas rare d'oxycéphalie révélée par un traumatisme crânien. Un jeune garçon de cinq ans s'est présenté avec une tuméfaction pariétale droite non réductible suite à une plaie cranio-cérébrale opérée à deux reprises à l’âge de trois ans puis six mois plus tard. Le bilan neuroradiologique a objectivé une hernie cérébrale avec empreintes digitiformes diffuses et une fusion des sutures crâniennes. Un bilan ophtalmologique a montré un strabisme convergent droit et un fond d’œil normal. Une chirurgie d'expansion crâniennea été réalisée. L’évolution post-opératoire était favorable. L'oxycéphalie harmonieuse peut passer inaperçue et un traumatisme crânien même bénin peut la révéler. PMID:26848359

  6. Tics and other stereotyped movements as side effects of pharmacological treatment.

    PubMed

    Madruga-Garrido, Marcos; Mir, Pablo

    2013-01-01

    Tics and other stereotyped abnormal movements can be seen as adverse effects of some pharmacologic drugs. Among these drugs, antipsychotics may provoke tardive syndromes after a chronic exposure, primarily in the case of typical antipsychotics. These syndromes include tardive tics, tardive dyskinesia, or tardive akathisia, which present with tics or stereotyped movements as a clinical phenomenon. Psychostimulants (mainly methylphenidate) have traditionally been associated with the appearance of tics due to the increased dopamine activity caused by stimulants. Nevertheless, in recent years, several studies have concluded not only that methylphenidate does not exacerbate or reactivate tics but also that tics can improve with its use in patients with associated attention deficit and hyperactivity disorder and tic disorder. Antiepileptic drugs, although infrequently, can also induce tics, with carbamazepine and lamotrigine described as tic inducers. Other antiepileptics, including levetiracetam and topiramate, have been proposed as a potential treatment for tic disorders due to a positive effect on tics, especially in those with associated epileptic disorder. Clinical and therapeutic approaches to tics and stereotyped movements after exposure to antipsychotics, stimulants, and antiepileptic drugs will be reviewed in this chapter. © 2013 Elsevier Inc. All rights reserved.

  7. New findings in pharmacogenetics of schizophrenia.

    PubMed

    Zai, Clement C; Tiwari, Arun K; Zai, Gwyneth C; Maes, Miriam S; Kennedy, James L

    2018-05-01

    This review highlights recent advances in the investigation of genetic factors for antipsychotic response and side effects. Antipsychotics prescribed to treat psychotic symptoms are variable in efficacy and propensity for causing side effects. The major side effects include tardive dyskinesia, antipsychotic-induced weight gain (AIWG), and clozapine-induced agranulocytosis (CIA). Several promising associations of polymorphisms in genes including HSPG2, CNR1, and DPP6 with tardive dyskinesia have been reported. In particular, a functional genetic polymorphism in SLC18A2, which is a target of recently approved tardive dyskinesia medication valbenazine, was associated with tardive dyskinesia. Similarly, several consistent findings primarily from genes modulating energy homeostasis have also been reported (e.g. MC4R, HTR2C). CIA has been consistently associated with polymorphisms in the HLA genes (HLA-DQB1 and HLA-B). The association findings between glutamate system genes and antipsychotic response require additional replications. The findings to date are promising and provide us a better understanding of the development of side effects and response to antipsychotics. However, more comprehensive investigations in large, well characterized samples will bring us closer to clinically actionable findings.

  8. Récidive de mélanome malin unguéal achromique: à propos d'un cas

    PubMed Central

    Benyass, Youssef; Chafry, Bouchaib; Koufagued, Kaldadak; Bouabid, Salim; Benchebba, Driss; Chagar, Belkacem

    2015-01-01

    Le mélanome malin unguéal représente 1,8 à 8,1% des mélanomes malins cutanés. Sa prise en charge s'adresse aujourd'hui aux praticiens de différentes spécialités. L'acte chirurgical initial est une étape incontournable du traitement curatif. La biopsie de la lésion doit être complète, afin de déterminer de façon exacte la profondeur de l'envahissement en cas de malignité. Nous rapportons un cas de mélanome malin achromique à localisation unguéal chez une femme. La chirurgie initiale consistait en une amputation transphalangienne proximale. L’évolution après deux ans était marquée par une récidive avec extension vers le carpe. Ayant subie une reprise chirurgicale avec une exérèse large. Le traitement des récidives est palliatif et vise à apporter un confort de vie au patient. Le principe du traitement fait appel à l'exérèse chirurgicale des lésions. Des alternatives thérapeutiques sont à l’étude. PMID:26977229

  9. Evaluation des résultats après traitement des lésions intra épithéliales du col utérin par la cryothérapie: étude préliminaire au Centre Hospitalier Universitaire de Yaoundé: A propos de 21 cas

    PubMed Central

    Ndoua, Claude Cyrille Noa; Tebeu, Pierre Marie; Kemfang, Jean Dupont; Kasia, Jean Marie

    2015-01-01

    Nous rapportons les résultats d'une série de 21 cas de prise en charge par cryothérapie de lésions intra-épithéliales cervicales au Centre Hospitalier et Universitaire (CHU) de Yaoundé. Notre objectif principal était d’évaluer les résultats préliminaires de la prise en charge des lésions précancéreuses éligibles pour la cryothérapie. Il s'agissait d'une étude transversale descriptive qui s'est étalée sur 24 mois. Etaient inclus dans l’étude toutes les femmes traitées par cryothérapie. Nous avons exclu les patientes traitées par une autre méthode, les patientes perdues de vue et les dossiers incomplets. Le statut cervical a été déterminé à 6 semaines, 6 mois et 12 mois. Les complications précoces et tardives ont également été répertoriées. Au total 95.2% des lésions étaient cicatrisées à 6 semaines. A 6 mois, toutes les lésions avaient disparu et au 12ème mois, la guérison était effective chez 95.2% des patientes. Les saignements et l'hydrorrhée étaient les principales complications tardives avec des fréquences respectives de 66.7% et 95.2%. Aucun cas de sténose cervicale n'a été répertorié. La cryothérapie peut être utilisée comme méthode de traitement pour des lésions précancéreuses du col. PMID:26140068

  10. Tumeurs Stromales Gastro-Intestinales «GIST»: état des lieux et actualités à travers notre expérience portant sur 54 cas et une Revue de littérature

    PubMed Central

    Taoufiq, Nezha; Naim, Asmaa; Bouchbika, Zineb; Benchekroune, Nadia; Jouhadi, Hassan; Sahraoui, Souha; Benider, Abdelatif

    2017-01-01

    Les Tumeurs Stromales Gastro-intestinales « GIST » sont une forme très rare de cancers du tube digestif appartenant à la famille des sarcomes. Le but de ce travail est d'établir le profil épidémiologique et évolutif ainsi que les difficultés diagnostique et thérapeutique de cette pathologie maligne prise en charge dans un pays en développement. Une Etude rétrospective étalée sur 8 ans de Janvier 2002 à Mars 2010, a été mené au Service de Radiothérapie et d'Oncologie du CHU de Casablanca (Maroc) ayant colligée 54 cas de tumeurs stromales gastro-intestinales. L'âge moyen de nos patients était de 55 ans. Le délai moyen d'évolution était de 11 mois (0-72 mois). La biopsie a permis de confirmer le diagnostic dans 14 cas et la chirurgie dans 40 cas. La principale forme histologique était fusiforme (92,6%). Les GIST dans notre série avaient une taille tumorale moyenne de 12,5 cm avec un C-Kit positif dans 52 cas. Le risque évolutif a pu être établi dans 47 cas dont 39 avaient un risque élevé. La chirurgie était le principal traitement des patients de notre sérieAprès un recul moyen de 31 mois, la moitié des patients évaluables de notre série (n=19) est en rémission complète maintenue, le tiers (n=13) est décédé alors que le quart (n=8) présente une récidive locale et /ou métastatique. Quoique les recommandations soient éditées pour la prise en charge de ces tumeurs, ces dernières soulèvent encore de nombreux problèmes aussi bien diagnostiques que thérapeutiques dans notre contexte. PMID:28904693

  11. Tardive dyskinesia

    MedlinePlus

    ... as levodopa Antiseizure drugs such as phenobarbital and phenytoin Symptoms Symptoms of TD may include: Facial grimacing ... ncbi.nlm.nih.gov/pubmed/23897874 . Jankovic J. Parkinson disease and other movement disorders. In: Daroff RB, ...

  12. Tardive Dyskinesia

    MedlinePlus

    ... Search form Sorry, we didn't find an account with that username and password. Please try again. Close Sign In to myNAMI signin form Forgot Sign In Create an Account Logging in... Learn More Find Support Get Involved ...

  13. Tardive Dyskinesia

    MedlinePlus

    ... Supplements Peer Review Process Review Committees Application Support Library Clinical Research Next Steps Pre-Funding: After Review Terms of ... Supplements Peer Review Process Review Committees Application Support Library Clinical Research Next Steps Pre-Funding: After Review Terms of ...

  14. The French Advanced Course for Deployment Surgery (ACDS) called Cours Avancé de Chirurgie en Mission Extérieure (CACHIRMEX): history of its development and future prospects.

    PubMed

    Bonnet, Stéphane; Gonzalez, F; Mathieu, L; Boddaert, G; Hornez, E; Bertani, A; Avaro, J-P; Durand, X; Rongieras, F; Balandraud, P; Rigal, S; Pons, F

    2016-10-01

    The composition of a French Forward Surgical Team (FST) has remained constant since its creation in the early 1950s: 12 personnel, including a general and an orthopaedic surgeon. The training of military surgeons, however, has had to evolve to adapt to the growing complexities of modern warfare injuries in the context of increasing subspecialisation within surgery. The Advanced Course for Deployment Surgery (ACDS)-called Cours Avancé de Chirurgie en Mission Extérieure (CACHIRMEX)-has been designed to extend, reinforce and adapt the surgical skill set of the FST that will be deployed. Created in 2007 by the French Military Health Service Academy (Ecole du Val-de-Grâce), this annual course is composed of five modules. The surgical knowledge and skills necessary to manage complex military trauma and give medical support to populations during deployment are provided through a combination of didactic lectures, deployment experience reports and hands-on workshops. The course is now a compulsory component of initial surgical training for junior military surgeons and part of the Continuous Medical Education programme for senior military surgeons. From 2012, the standardised content of the ACDS paved the way for the development of two more team-training courses: the FST and the Special Operation Surgical Team training. The content of this French military original war surgery course is described, emphasising its practical implications and future prospects. The military surgical training needs to be regularly assessed to deliver the best quality of care in an context of evolving modern warfare casualties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Efficacy of Valbenazine (NBI-98854) in Treating Subjects with Tardive Dyskinesia and Mood Disorder.

    PubMed

    Correll, Christoph U; Josiassen, Richard C; Liang, Grace S; Burke, Joshua; O'Brien, Christopher F

    2017-08-01

    Valbenazine (VBZ, NBI-98854) is a novel vesicular monoamine transporter 2 (VMAT2) inhibitor approved for the treatment of tardive dyskinesia (TD). The KINECT 3 study (NCT02274558) evaluated the effects of VBZ on TD in subjects with mood disorder or schizophrenia/schizoaffective disorder (SCHZ, presented separately) who received up to 48 weeks of treatment. KINECT 3 included: 6-week, double-blind, placebo (PBO)-controlled (DBPC) period (205 completers); 42-week VBZ extension (VE) period (124 completers); 4-week washout period (121 completers). Subjects entering the DBPC were randomized 1:1:1 to once-daily VBZ 80 mg, VBZ 40 mg, or PBO; stable concomitant antipsychotic medication regimens were allowed. Subjects completing the DBPC and entering the VE period were re-randomized (blinded) from PBO to VBZ (80 or 40 mg) or continued VBZ treatment at the same dose. Efficacy assessments included: mean changes from baseline in Abnormal Involuntary Movement Scale (AIMS) total score (items 1-7); mean Clinical Global Impression of Change (CGI-TD) scores; AIMS responders (subjects with ≥50% score reduction from baseline); and CGI-TD responders (subjects with score ≤2 ["much improved" or "very much improved"]). Treatment effect sizes (Cohen's d) and numbers needed to treat (NNTs) were analyzed for DBPC outcomes. Efficacy analyses were conducted in 77 subjects (DBPC) and 73 subjects (VE) with a mood disorder. At Week 6 (end of DBPC), AIMS mean score improvements were greater in the VBZ groups (in a dose-related pattern) than in the PBO group (80 mg, -3.6, d = 0.94; 40 mg, -2.4, d = 0.55; PBO, -0.7). AIMS mean score changes at Week 48 (end of VE) showed continued TD improvement during long-term VBZ treatment (80 mg, -5.8; 40 mg, -4.2). By Week 52 (end of washout), AIMS mean scores in both dose groups were returning toward baseline levels, indicating re-emergence of TD. CGI-TD scores showed a similar pattern: Week 6 (80 mg, 2.7, d = 0.64; 40 mg, 2.9, d = 0.39; PBO, 3.2), Week 48

  16. SA17. Response to Treatment With Valbenazine (NBI-98854) in Subjects With Tardive Dyskinesia

    PubMed Central

    Kane, John; Josiassen, Richard; Burke, Joshua; Jimenez, Roland; Siegert, Scott; Liang, Grace

    2017-01-01

    Abstract Background: Tardive dyskinesia (TD) is a persistent and potentially disabling movement disorder resulting from exposure to dopamine receptor-blocking agents (DRBAs), such as antipsychotics. Valbenazine is a novel and highly selective vesicular monoamine transporter 2 (VMAT2) inhibitor that is being evaluated for the treatment of TD and other movement disorders. Clinical studies include a Phase 3 trial of valbenazine in adults who had TD and underlying schizophrenia/schizoaffective disorder or mood disorder (KINECT 3; NCT02274558). The primary end point of this trial was met as demonstrated by a significant difference between valbenazine 80 mg/day and placebo for the Abnormal Involuntary Movement Scale (AIMS) dyskinesia total score (Items 1–7) change from baseline. Additional analyses of AIMS data from this trial were conducted to assess treatment response in subjects with TD. Methods: In this 6-week, double-blind, placebo-controlled trial, subjects were randomized 1:1:1 to once-daily treatment with valbenazine 80 mg, valbenazine 40 mg, or placebo. Treatment response was defined as ≥50% reduction in the AIMS total score. AIMS responders were analyzed by study visit (Weeks 2, 4, and 6) in the intent-to-treat (ITT) population and in subgroups categorized by underlying psychiatric diagnosis (schizophrenia/schizoaffective disorder or mood disorder). Numbers needed to treat (NNTs) were calculated for AIMS responders (valbenazine vs placebo) at Week 6. Significance testing was not conducted in the subgroups. Results: At Week 6 in the ITT population (N = 225), AIMS responder rates were significantly higher with valbenazine than with placebo: 80 mg, 40.0% (P < .0001; NNT = 4); 40 mg, 23.8% (P = .0200; NNT=7); placebo, 8.7%. Treatment with valbenazine 80 mg versus placebo also resulted in significantly higher responder rates at Week 2 (23.4% vs 5.3%, P = .0016) and Week 4 (28.8% vs 9.7%, P = 0.0039). Subjects treated with valbenazine 40

  17. Validation of the All Patient Refined Diagnosis Related Group (APR-DRG) Risk of Mortality and Severity of Illness Modifiers as a Measure of Perioperative Risk.

    PubMed

    McCormick, Patrick J; Lin, Hung-Mo; Deiner, Stacie G; Levin, Matthew A

    2018-03-22

    The All Patient Refined Diagnosis Related Group (APR-DRG) is an inpatient visit classification system that assigns a diagnostic related group, a Risk of Mortality (ROM) subclass and a Severity of Illness (SOI) subclass. While extensively used for cost adjustment, no study has compared the APR-DRG subclass modifiers to the popular Charlson Comorbidity Index as a measure of comorbidity severity in models for perioperative in-hospital mortality. In this study we attempt to validate the use of these subclasses to predict mortality in a cohort of surgical patients. We analyzed all adult (age over 18 years) inpatient non-cardiac surgery at our institution between December 2005 and July 2013. After exclusions, we split the cohort into training and validation sets. We created prediction models of inpatient mortality using the Charlson Comorbidity Index, ROM only, SOI only, and ROM with SOI. Models were compared by receiver-operator characteristic (ROC) curve, area under the ROC curve (AUC), and Brier score. After exclusions, we analyzed 63,681 patient-visits. Overall in-hospital mortality was 1.3%. The median number of ICD-9-CM diagnosis codes was 6 (Q1-Q3 4-10). The median Charlson Comorbidity Index was 0 (Q1-Q3 0-2). When the model was applied to the validation set, the c-statistic for Charlson was 0.865, c-statistic for ROM was 0.975, and for ROM and SOI combined the c-statistic was 0.977. The scaled Brier score for Charlson was 0.044, Brier for ROM only was 0.230, and Brier for ROM and SOI was 0.257. The APR-DRG ROM or SOI subclasses are better predictors than the Charlson Comorbidity Index of in-hospital mortality among surgical patients.

  18. Fuel assembly design for APR1400 with low CBC

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

    Hah, Chang Joo, E-mail: changhah@kings.ac.kr

    2015-04-29

    APR 1400 is a PWR (Pressurized Water Reactor) with rated power of 3983 MWth and 241 assemblies. Recently, demand for extremely longer cycle up to 24 months is increasing with challenge of higher critical boron concentration (CBC). In this paper, assembly design method of selecting Gd-rods is introduced to reduce CBC. The purpose of the method is to lower the critical boron concentration of the preliminary core loading pattern (PLP), and consequently to achieve more negative or less positive moderator temperature coefficient (MTC). In this method, both the ratio of the number of low-Gd rod to the number of high-Gdmore » rod (r) and assembly average Gd wt% (w) are the decision variables. The target function is the amount of soluble boron concentration reduction, which can be converted to Δk{sub TARGET}. A set of new designed fuel assembly satisfies an objective function, min [f=∑{sub i}(Δk{sub FA}−Δk{sub i})], and enables a final loading pattern to reach a target CBC. The constraints required to determine a set of Δk are physically realizable pair, (r,w), and the sum of Δk of new designed assemblies as close to Δk{sub TARGET} as possible. New Gd-bearing assemblies selected based on valid pairs of (r,w) are replaced with existing assemblies in a PLP. This design methodology is applied to Shin-Kori Unit 3 Cycle 1 used as a reference model. CASMO-3/MASTER code is used for depletion calculation. CASMO-3/MASTER calculations with new designed assemblies produce lower CBC than the expected CBC, proving that the proposed method works successful.« less

  19. Efficacy of Valbenazine (NBI-98854) in Treating Subjects with Tardive Dyskinesia and Mood Disorder

    PubMed Central

    Correll, Christoph U.; Josiassen, Richard C.; Liang, Grace S.; Burke, Joshua; O’Brien, Christopher F.

    2017-01-01

    Background Valbenazine (VBZ, NBI-98854) is a novel vesicular monoamine transporter 2 (VMAT2) inhibitor approved for the treatment of tardive dyskinesia (TD). The KINECT 3 study (NCT02274558) evaluated the effects of VBZ on TD in subjects with mood disorder or schizophrenia/schizoaffective disorder (SCHZ, presented separately) who received up to 48 weeks of treatment. Methods KINECT 3 included: 6-week, double-blind, placebo (PBO)-controlled (DBPC) period (205 completers); 42-week VBZ extension (VE) period (124 completers); 4-week washout period (121 completers). Subjects entering the DBPC were randomized 1:1:1 to once-daily VBZ 80 mg, VBZ 40 mg, or PBO; stable concomitant antipsychotic medication regimens were allowed. Subjects completing the DBPC and entering the VE period were re-randomized (blinded) from PBO to VBZ (80 or 40 mg) or continued VBZ treatment at the same dose. Efficacy assessments included: mean changes from baseline in Abnormal Involuntary Movement Scale (AIMS) total score (items 1–7); mean Clinical Global Impression of Change (CGI-TD) scores; AIMS responders (subjects with ≥50% score reduction from baseline); and CGI-TD responders (subjects with score ≤2 [“much improved” or “very much improved”]). Treatment effect sizes (Cohen’s d) and numbers needed to treat (NNTs) were analyzed for DBPC outcomes. Results Efficacy analyses were conducted in 77 subjects (DBPC) and 73 subjects (VE) with a mood disorder. At Week 6 (end of DBPC), AIMS mean score improvements were greater in the VBZ groups (in a dose-related pattern) than in the PBO group (80 mg, -3.6, d = 0.94; 40 mg, -2.4, d = 0.55; PBO, -0.7). AIMS mean score changes at Week 48 (end of VE) showed continued TD improvement during long-term VBZ treatment (80 mg, -5.8; 40 mg, -4.2). By Week 52 (end of washout), AIMS mean scores in both dose groups were returning toward baseline levels, indicating re-emergence of TD. CGI-TD scores showed a similar pattern: Week 6 (80 mg, 2.7, d = 0.64; 40

  20. Épidémiologie des brûlures de la main chez les enfants vus dans le Centre National des Brûlés et de Chirurgie Plastique de Casablanca, Maroc

    PubMed Central

    Rafik, A.; Lahlou, M.; Diouri, M.; Bahechar, N.; Chlihi, A.

    2015-01-01

    Summary Les brûlures de la main chez l’enfant constituent une source de séquelles invalidantes. A cet régard, la conservation et la restauration complète de la fonction de la main demeurent le but primordial de la prise en charge. Afin de répertorier les caractéristiques épidémiologiques, cliniques et évolutives des mains brûlées, nous avons réalisé une étude rétrospective étalée sur 4 ans, de janvier 2011 à janvier 2015. Cette étude a permis de colliger les cas de 313 enfants atteints de brûlure de la main vus dans le Centre National des Brulés et de Chirurgie Plastique du CHU Ibn Rochd de Casablanca. La majorité des brûlures touche les enfants de 3 à 6 ans (70% des cas), avec une légère prédominance masculine. La principale cause des brûlures survenant à cet âge est l’ébouillantement. Les brûlures par flamme représentent 33% des cas, celles par électricité 4,5%. Les brûlures chimiques et par contact sont anecdotiques (1 cas chacune). L’accident survient le plus souvent à domicile. Soixante douze pour cent des brûlures ont guéri spontanément. Afin de diminuer l’incidence de ces accidents, une approche préventive faite de sensibilisation et d’éducation devrait faire partie du cursus scolaire. PMID:27777543

  1. Deanol acetamidobenzoate treatment in choreiform movement disorders.

    PubMed

    Tarsy, D; Bralower, M

    1977-12-01

    Deanol acetamidobenzoate was administered in double-blind, crossover fashion with placebo to five patients with tardive dyskinesia, three patients with Huntington's chorea, and one patient with posthemiplegic chorea. No significant effect on dyskinesia was observed. Preliminary administration of physostigmine salicylate to patients with tardive dyskinesia had a variable effect, while benztropine mesylate produced no change. Since the status of deanol as an effective precursor of acetylcholine is uncertain, further trials with putative cholinergic agents remain warranted in choreiform syndromes.

  2. Acute Cervical Dystonia Induced by Clebopride.

    PubMed

    Choi, Jin Kyo; Hong, Jin Yong

    2017-01-01

    Antidopaminergic drugs are known to induce extrapyramidal symptoms. Clebopride, a dopamine antagonist, also can produce parkinsonism, tardive dyskinesia, tardive dystonia, hemifacial dystonia, or oculogyric crisis; however, acute dystonic reaction caused by clebopride has not been reported in adults. We report two young men who experienced acute cervical dystonia within a few days of taking clebopride. The patients recovered after discontinuation of the drug. Physicians prescribing clebopride should be aware of the adverse effects of this drug.

  3. Acute Cervical Dystonia Induced by Clebopride

    PubMed Central

    2017-01-01

    Antidopaminergic drugs are known to induce extrapyramidal symptoms. Clebopride, a dopamine antagonist, also can produce parkinsonism, tardive dyskinesia, tardive dystonia, hemifacial dystonia, or oculogyric crisis; however, acute dystonic reaction caused by clebopride has not been reported in adults. We report two young men who experienced acute cervical dystonia within a few days of taking clebopride. The patients recovered after discontinuation of the drug. Physicians prescribing clebopride should be aware of the adverse effects of this drug. PMID:29333306

  4. Efficacy of Valbenazine (NBI-98854) in Treating Subjects with Tardive Dyskinesia and Schizophrenia or Schizoaffective Disorder

    PubMed Central

    Kane, John M.; Correll, Christoph U.; Liang, Grace S.; Burke, Joshua; O’Brien, Christopher F.

    2017-01-01

    Background Valbenazine (VBZ, NBI-98854) is a novel vesicular monoamine transporter 2 (VMAT2) inhibitor approved for the treatment of tardive dyskinesia (TD). The KINECT 3 study (NCT02274558) evaluated the effects of VBZ on TD in subjects with schizophrenia/schizoaffective disorder (SCHZ) or mood disorder (mood disorder presented separately) who received up to 48 weeks of treatment. Methods KINECT 3 included: 6-week, double-blind, placebo (PBO)-controlled (DBPC) period (205 completers); 42-week VBZ extension (VE) period (124 completers): 4-week washout period (121 completers). Subjects entering the DBPC were randomized 1:1:1 to once-daily VBZ 80 mg, VBZ 40 mg, or PBO; stable concomitant antipsychotic medication regimens were allowed. Subjects completing the DBPC and entering the VE period were re-randomized (blinded) 1:1 from PBO to VBZ (80 or 40 mg) or continued VBZ treatment at the same dose. Efficacy assessments included: mean changes from baseline in Abnormal Involuntary Movement Scale (AIMS) total score (items 1–7); mean Clinical Global Impression of Change (CGI-TD) scores; AIMS responders (subjects with ≥50% score reduction from baseline): and CGI-TD responders (subjects with score ≤2 [“much improved” or “very much improved”]). Treatment effect sizes (Cohen’s d) and numbers needed to treat (NNTs) were analyzed for DBPC outcomes. Results Efficacy analyses were conducted in 148 subjects (DBPC) and 125 subjects (VE) with SCHZ. At Week 6 (end of DBPC), AIMS mean score improvements were greater in the VBZ groups (in a dose-related pattern) than in the PBO group (80 mg, -2.9, d = 0.88; 40 mg, -1.6, d = 0.52; PBO, +0.3). AIMS score changes at Week 48 (end of VE) showed continued TD improvement during long-term VBZ treatment (80 mg, -4.2; 40 mg, -2.5). By Week 52 (end of washout), AIMS scores were returning toward baseline levels, indicating re-emergence of TD. CGI-TD mean scores were as follows: Week 6 (80 mg, 3.0, d = 0.11; 40 mg, 2.9, d = 0.23; PBO

  5. Efficacy of Valbenazine (NBI-98854) in Treating Subjects with Tardive Dyskinesia and Schizophrenia or Schizoaffective Disorder.

    PubMed

    Kane, John M; Correll, Christoph U; Liang, Grace S; Burke, Joshua; O'Brien, Christopher F

    2017-08-01

    Valbenazine (VBZ, NBI-98854) is a novel vesicular monoamine transporter 2 (VMAT2) inhibitor approved for the treatment of tardive dyskinesia (TD). The KINECT 3 study (NCT02274558) evaluated the effects of VBZ on TD in subjects with schizophrenia/schizoaffective disorder (SCHZ) or mood disorder (mood disorder presented separately) who received up to 48 weeks of treatment. KINECT 3 included: 6-week, double-blind, placebo (PBO)-controlled (DBPC) period (205 completers); 42-week VBZ extension (VE) period (124 completers): 4-week washout period (121 completers). Subjects entering the DBPC were randomized 1:1:1 to once-daily VBZ 80 mg, VBZ 40 mg, or PBO; stable concomitant antipsychotic medication regimens were allowed. Subjects completing the DBPC and entering the VE period were re-randomized (blinded) 1:1 from PBO to VBZ (80 or 40 mg) or continued VBZ treatment at the same dose. Efficacy assessments included: mean changes from baseline in Abnormal Involuntary Movement Scale (AIMS) total score (items 1-7); mean Clinical Global Impression of Change (CGI-TD) scores; AIMS responders (subjects with ≥50% score reduction from baseline): and CGI-TD responders (subjects with score ≤2 ["much improved" or "very much improved"]). Treatment effect sizes (Cohen's d) and numbers needed to treat (NNTs) were analyzed for DBPC outcomes. Efficacy analyses were conducted in 148 subjects (DBPC) and 125 subjects (VE) with SCHZ. At Week 6 (end of DBPC), AIMS mean score improvements were greater in the VBZ groups (in a dose-related pattern) than in the PBO group (80 mg, -2.9, d = 0.88; 40 mg, -1.6, d = 0.52; PBO, +0.3). AIMS score changes at Week 48 (end of VE) showed continued TD improvement during long-term VBZ treatment (80 mg, -4.2; 40 mg, -2.5). By Week 52 (end of washout), AIMS scores were returning toward baseline levels, indicating re-emergence of TD. CGI-TD mean scores were as follows: Week 6 (80 mg, 3.0, d = 0.11; 40 mg, 2.9, d = 0.23; PBO, 3.2), Week 48 (80 mg, 2.2; 40 mg, 2

  6. Le dermatofibrosarcome de Darier et Ferrand, une tumeur cutanée particulière: à propos de 32 cas et revue de la littérature

    PubMed Central

    Elamrani, Driss; Droussi, Hatim; Boukind, Samira; Elatiqi, Keltoum; Dlimi, Meriem; Benchamkha, Yassine; Ettalbi, Saloua

    2014-01-01

    Le dermatofibrosarcome (DFS) est une tumeur fibreuse de la peau, de croissance lente, à très haut risque de récidive locale, mais à potentiel métastatique faible. A partir d'une étude rétrospective étalée sur une période de 5 ans (décembre 2008 - décembre 2013), nous avons analysé les caractéristiques épidémiologiques et cliniques, le délai de diagnostic, le type de thérapeutique et le devenir de 32 patients présentant des tumeurs de Darier et Ferrand histologiquement prouvées. Parmi les 32 patients, 10 se sont présentés initialement au service pour une récidive tumorale. Une discrète prédominance masculine a été notée. Les DFS touchent préférentiellement l'adulte jeune. Le délai diagnostique observé est en moyenne de 4 ans. Le tronc est la localisation préférentielle (60%), suivi par les extrémités proximales (30%). Les 32 patients ont été traités par exérèse chirurgicale avec une marge de 5cm en surface, emportant en profondeur une barrière anatomique saine. La couverture de la perte de substance (PDS) a été réalisée après confirmation anatomopathologique du caractère carcinologique de l'exérèse, et a fait appel à différents moyens allant de la greffe cutanée aux lambeaux musculo –cutanés libres. L’évolution a été marquée par la survenue d'une récidive tumorale chez 8 patients (3 cas parmi les tumeurs vues en première intention et 5 cas parmi les tumeurs vues en récidive) et les résultats ont été jugés satisfaisants sur le plan esthétique et fonctionnel. Le DFS de Darier et Ferrand est une tumeur dont le pronostic et le risque évolutif sont principalement liés au délai diagnostic et la qualité de la première exérèse. Le diagnostic tardif, rend difficile la chirurgie d'exérèse et de reconstruction Les possibilités de guérison en cas de chirurgie primaire bien conduite sont significativement supérieures à celles d'une chirurgie de rattrapage. L'amélioration du pronostic passe par

  7. Labelling as reference Centre of GRACE (Groupe francophone de Réhabilitation Améliorée après ChirurgiE) for colorectal surgery: its impact on the implementation of enhanced recovery programme at the University Hospital of Liège.

    PubMed

    Daenen, Coralie; Coimbra, Carla; Hans, Grégory; Joris, Jean

    2018-01-15

    Enhanced recovery programme (ERP) has been used in our hospital since 2005 for selected colorectal surgeries. Since October 2015, after labelling as GRACE reference centre, we included all patients scheduled for elective colorectal surgery in this programme. We assessed the impact of our labelling on the implementation of ERP. Results of our first 100 patients entered in the GRACE database were analyzed: length of stay, complications, readmission, adherence to the protocol. These results are compared to those of the last 100 patients undergoing colorectal surgery before our labelling. Patients' characteristics in both groups were similar. The complications rate was similar in both groups. The global length of hospital stay was 4 [5] days vs. 8.5 [8] (median [IQR]), respectively after and before labelling; p < .001. The duration of hospitalization for the different subgroups (age, surgical approach, types of surgery) were significantly shorter after our labelling (respectively: p < .001, p < .01, and p < .05). Our results demonstrate that labelling as reference centre increases the efficiency of the implementation of ERP. The fact that all subgroups of patients benefit from ERP must encourage inclusion of all patients undergoing elective colorectal surgery in ERP.

  8. Epithelioma Spinocellulaire sur Cicatrice de Brulure (a Propos de Cinq Cas)

    PubMed Central

    Tourabi, K.; Mejjati, H.; Ribqg, Y.; Achbouk, A.; Arrob, A.; Moussaoui, A.; Ihrai, H.

    2009-01-01

    Summary Pour étudier l'ulcère de Marjolin, tous les dossiers des patients qui se sont présentés pendant une période quinquennale à un Service de Chirurgie Plastique et des Brûlés au Maroc ayant un cancer sur cicatrice de brûlure, objectivé par un examen histopathologique, ont été inclus dans une fiche de recueil de données comprenant des paramètres liés à l'identité du malade, à l'inventaire préthérapeutique, au traitement et à l'évolution du cas. Les Auteurs, après avoir présenté les données des cinq patients inclus dans l'étude, considèrent les problèmes posés par les épithéliomas spinocellulaires sur cicatrice de brûlure, qui sont des affections graves et rares. La dégénérescence des cicatrices de brûlures est une évolution dramatique, causée par la négligence. Le traitement préventif par exérèse systématique de toute lésion suspecte doit être fortement souligné puisqu'il garantit la guérison quasi certaine. PMID:21991185

  9. La replantation digitale, résultats et complications: étude d’une série de 18 cas

    PubMed Central

    Idrissi, Mohammed El; Elibrahimi, Abdelhalim; Shimi, Mohammed; Elmrini, Abdelmajid

    2016-01-01

    Les amputations digitales sont des lésions fréquentes, la majorité étant provoquée par des accidents de travail. Les techniques microchirurgicales représentent une alternative pour réparer ces amputations. L'objectif de ce travail est de rapporter notre expérience dans la replantation digitale à travers l'étude de 18 cas. Nous avons mené une étude rétrospective, étalée entre Juin 2013 et Janvier 2015, incluant 14 patients présentant une amputation totale ou subtotale des doigts. Nous avons inclus dans notre série toutes les replantations unidigitales et multidigitales réalisées en aval de l'insertion distale du tendon fléchisseur superficiel ainsi que les replantations digitales réalisées en amont de l'insertion distale du tendon fléchisseur superficiel. Nous avons opéré ces patients selon le procédé classique de réimplantation digitale. Cinq replantations ont été secondairement régularisées. Parmi les 18 replantations, huit replantions digitales ont favorablement évolué puisque la replantation a permis de restituer un secteur complet de mobilité passive et active du doigt opéré sans chirurgie de reprise et sans complication secondaire précoce et tardive. Dans notre étude nous avons noté des résultats satisfaisants, malgré les conditions difficiles notamment le conditionnement initial du doigt amputé, et le délai de prise en charge retardé. Le développement et la maîtrise de la microchirurgie a permis de changer le pronostic de ces amputations à retentissement fonctionnel et psychologique difficile, les résultats de notre série sont encourageants pour a mise en place d'un service SOS main au Maroc. PMID:27795781

  10. Nicotine Reduces Antipsychotic-Induced Orofacial Dyskinesia in Rats

    PubMed Central

    Bordia, Tanuja; McIntosh, J. Michael

    2012-01-01

    Antipsychotics are an important class of drugs for the management of schizophrenia and other psychotic disorders. They act by blocking dopamine receptors; however, because these receptors are present throughout the brain, prolonged antipsychotic use also leads to serious side effects. These include tardive dyskinesia, repetitive abnormal involuntary movements of the face and limbs for which there is little treatment. In this study, we investigated whether nicotine administration could reduce tardive dyskinesia because nicotine attenuates other drug-induced abnormal movements. We used a well established model of tardive dyskinesia in which rats injected with the commonly used antipsychotic haloperidol develop vacuous chewing movements (VCMs) that resemble human orofacial dyskinesias. Rats were first administered nicotine (minipump; 2 mg/kg per day). Two weeks later, they were given haloperidol (1 mg/kg s.c.) once daily. Nicotine treatment reduced haloperidol-induced VCMs by ∼20% after 5 weeks, with a significant ∼60% decline after 13 weeks. There was no worsening of haloperidol-induced catalepsy. To understand the molecular basis for this improvement, we measured the striatal dopamine transporter and nicotinic acetylcholine receptors (nAChRs). Both haloperidol and nicotine treatment decreased the transporter and α6β2* nAChRs (the asterisk indicates the possible presence of other nicotinic subunits in the receptor complex) when given alone, with no further decline with combined drug treatment. By contrast, nicotine alone increased, while haloperidol reduced α4β2* nAChRs in both vehicle and haloperidol-treated rats. These data suggest that molecular mechanisms other than those directly linked to the transporter and nAChRs underlie the nicotine-mediated improvement in haloperidol-induced VCMs in rats. The present results are the first to suggest that nicotine may be useful for improving the tardive dyskinesia associated with antipsychotic use. PMID:22144565

  11. Pharmaceutical Approval Update.

    PubMed

    Kaufman, Michele B

    2017-09-01

    Sarilumab (Kevzara) for moderately to severely active rheumatoid arthritis; valbenazine (Ingrezza), the first approval for tardive dyskinesia; and cerliponase alpha (Brineura) for late infantile neuronal ceroid lipofuscinosis type-2 disease.

  12. Suivi après le traitement du cancer du sein

    PubMed Central

    Sisler, Jeffrey; Chaput, Geneviève; Sussman, Jonathan; Ozokwelu, Emmanuel

    2016-01-01

    Résumé Objectif Offrir aux médecins de famille un résumé des recommandations fondées sur les données probantes pour guider les soins aux survivantes traitées pour le cancer du sein. Qualité des données Une recherche documentaire a été effectuée dans MEDLINE entre 2000 et 2016 à l’aide des mots-clés anglais suivants : breast cancer, survivorship, follow-up care, aftercare, guidelines et survivorship care plans, en se concentrant sur la revue des lignes directrices publiées récemment par les organismes nationaux de cancérologie. Les données étaient de niveaux I à III. Message principal Les soins aux survivantes comportent 4 facettes : surveillance et dépistage, prise en charge des effets à long terme, promotion de la santé et coordination des soins. La surveillance des récidives ne se traduit que par une mammographie annuelle, et le dépistage d’autres cancers doit suivre les lignes directrices basées sur la population. La prise en charge des effets à long terme du cancer et de son traitement aborde des problèmes courants tels la douleur, la fatigue, le lymphœdème, la détresse et les effets indésirables des médicaments, de même que les préoccupations à long terme comme la santé du cœur et des os. La promotion de la santé met en relief les bienfaits de l’activité chez les survivantes du cancer, avec l’accent mis sur l’activité physique. Les soins aux survivantes sont de meilleure qualité lorsque divers services et professionnels de la santé participent aux soins, et le médecin de famille joue un rôle important dans la coordination des soins. Conclusion Les médecins de famille sont de plus en plus souvent les principaux fournisseurs de soins de suivi après le traitement du cancer du sein. Le cancer du sein doit être considéré comme une affection médicale chronique, même chez les femmes en rémission, et les patientes profitent de la même approche que celle utilisée pour les autres affections chroniques en

  13. Long-Term Safety and Tolerability of Valbenazine (NBI-98854) in Subjects with Tardive Dyskinesia and a Diagnosis of Schizophrenia or Mood Disorder

    PubMed Central

    Josiassen, Richard C.; Kane, John M.; Liang, Grace S.; Burke, Joshua; O’Brien, Christopher F.

    2017-01-01

    Background The short-term safety profile of once-daily valbenazine (NBI-98854) has been evaluated in several double-blind, placebo-controlled (DBPC) trials in adults with tardive dyskinesia (TD) who had a diagnosis of schizophrenia/schizoaffective (SCHZ) disorder or mood disorder. Studies with longer treatment duration (up to 48 weeks) were conducted to evaluate the long-term safety of this novel drug in subjects with TD. Methods The pooled long-term exposure (LTE) population included valbenazine-treated subjects from 3 studies: KINECT (NCT01688037: 6-week DBPC, 6-week open-label); KINECT 3 (NCT02274558: 6-week DBPC, 42-week blinded extension, 4-week drug-free follow-up); KINECT 4 (NCT02405091: 48-week open-label, 4-week drug-free follow-up). Safety assessments included adverse events (AEs), laboratory tests, vital signs, electrocardiograms (ECGs), and extrapyramidal symptom (EPS) scales. Psychiatric stability was monitored using the Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) (SCHZ subgroup), as well as the Montgomery-Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) (mood subgroup). All data were analyzed descriptively. Results The LTE population included 430 subjects (KINECT, n = 46; KINECT 3, n = 220; KINECT 4, n = 164), 71.7% with SCHZ and 28.3% with a mood disorder; 85.5% were taking an antipsychotic (atypical only, 69.8%; typical only or typical + atypical, 15.7%). In the LTE population, treatment-emergent AEs (TEAEs) and discontinuations due to AEs were reported in 66.5% and 14.7% of subjects, respectively. The TEAE incidence was lower in the SCHZ subgroup (64.4%) than in the mood subgroup (71.9%). The 3 most common TEAEs in the SCHZ subgroup were urinary tract infection (UTI, 6.1%), headache (5.8%), and somnolence (5.2%). The 3 most common TEAEs in the mood subgroup were headache (12.4%), UTI (10.7%), and somnolence (9.1%). Mean score changes from baseline to end of treatment

  14. Long-Term Safety and Tolerability of Valbenazine (NBI-98854) in Subjects with Tardive Dyskinesia and a Diagnosis of Schizophrenia or Mood Disorder.

    PubMed

    Josiassen, Richard C; Kane, John M; Liang, Grace S; Burke, Joshua; O'Brien, Christopher F

    2017-08-01

    The short-term safety profile of once-daily valbenazine (NBI-98854) has been evaluated in several double-blind, placebo-controlled (DBPC) trials in adults with tardive dyskinesia (TD) who had a diagnosis of schizophrenia/schizoaffective (SCHZ) disorder or mood disorder. Studies with longer treatment duration (up to 48 weeks) were conducted to evaluate the long-term safety of this novel drug in subjects with TD. The pooled long-term exposure (LTE) population included valbenazine-treated subjects from 3 studies: KINECT (NCT01688037: 6-week DBPC, 6-week open-label); KINECT 3 (NCT02274558: 6-week DBPC, 42-week blinded extension, 4-week drug-free follow-up); KINECT 4 (NCT02405091: 48-week open-label, 4-week drug-free follow-up). Safety assessments included adverse events (AEs), laboratory tests, vital signs, electrocardiograms (ECGs), and extrapyramidal symptom (EPS) scales. Psychiatric stability was monitored using the Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) (SCHZ subgroup), as well as the Montgomery-Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) (mood subgroup). All data were analyzed descriptively. The LTE population included 430 subjects (KINECT, n = 46; KINECT 3, n = 220; KINECT 4, n = 164), 71.7% with SCHZ and 28.3% with a mood disorder; 85.5% were taking an antipsychotic (atypical only, 69.8%; typical only or typical + atypical, 15.7%). In the LTE population, treatment-emergent AEs (TEAEs) and discontinuations due to AEs were reported in 66.5% and 14.7% of subjects, respectively. The TEAE incidence was lower in the SCHZ subgroup (64.4%) than in the mood subgroup (71.9%). The 3 most common TEAEs in the SCHZ subgroup were urinary tract infection (UTI, 6.1%), headache (5.8%), and somnolence (5.2%). The 3 most common TEAEs in the mood subgroup were headache (12.4%), UTI (10.7%), and somnolence (9.1%). Mean score changes from baseline to end of treatment (Week 48) indicated that

  15. Étude de la perméabilité de la barrière hémato-encéphalique par microdialyse après irradiation photonique monofractionnée chez le rat

    NASA Astrophysics Data System (ADS)

    Agin, A.; Martin, C.; Mauris, J.; Staali, F.; Diserbo, M.

    1999-01-01

    The effects of total-body irradiation on the permeability of rat striatal blood-brain barrier (BBB) to [ ^3H] aminoisobutyric acid (AIBA) and [ 14C] sucrose were investigated. Seven days, 6 weeks, 3 and 5 months after gamma exposure at the dose of 4.5 Gy, no modification of the permeability to both [ ^3H] AIBA and [ 14C] sucrose was observed. A transient “opening" of the BBB to [ 14C] sucrose was noticed about 28 hours following irradiation. The transport of [3H] AIBA through BBB was decreased between the 33^th and the 47^th post-radiation hour. Nous avons étudié, dans le striatum de rat, les effets d'une irradiation globale aiguë sur la perméabilité de la barrière hémato-encéphalique à l'acide [ ^3H] aminoisobutyrique et au [ 14C] saccharose. Sept jours, 6 semaines, 3 et 5 mois après exposition γ à la dose de 4,5 Gy, aucune altération de la perméabilité aux deux marqueurs n'a été observée. Une “ouverture" transitoire de la BHE au [ 14C] saccharose est notée vers la 28e heure suivant l'irradiation. Le transport du [ ^3H] aminoisobutyrate est diminué entre 33 et 47 heures après irradiation.

  16. [Writing for the HaMiPla].

    PubMed

    Prommersberger, K-J; Giunta, R E

    2012-10-01

    This paper describes from the editors' perspective step-by-step how to configure and write a manuscript for the Handchirurgie Mikrochirurgie Plastische Chirurgie with the goal to make a successful and quick publication easier. © Georg Thieme Verlag KG Stuttgart · New York.

  17. [Chemists and chemistry in the Journal of Medicine, Surgery, Pharmacy &c., from 1754 until 1791].

    PubMed

    Fournier, Josette

    2006-01-01

    Since its coming out (1754) until the publication of the Annales de chimie (1789), the Journal de Médecine, Chirurgie, Pharmacie, &c. received papers and pieces of news from chemists; many of them cultivated their love for chemistry while they practised health professions.

  18. Experimental and code simulation of a station blackout scenario for APR1400 with test facility ATLAS and MARS code

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

    Yu, X. G.; Kim, Y. S.; Choi, K. Y.

    2012-07-01

    A SBO (station blackout) experiment named SBO-01 was performed at full-pressure IET (Integral Effect Test) facility ATLAS (Advanced Test Loop for Accident Simulation) which is scaled down from the APR1400 (Advanced Power Reactor 1400 MWe). In this study, the transient of SBO-01 is discussed and is subdivided into three phases: the SG fluid loss phase, the RCS fluid loss phase, and the core coolant depletion and core heatup phase. In addition, the typical phenomena in SBO-01 test - SG dryout, natural circulation, core coolant boiling, the PRZ full, core heat-up - are identified. Furthermore, the SBO-01 test is reproduced bymore » the MARS code calculation with the ATLAS model which represents the ATLAS test facility. The experimental and calculated transients are then compared and discussed. The comparison reveals there was malfunction of equipments: the SG leakage through SG MSSV and the measurement error of loop flow meter. As the ATLAS model is validated against the experimental results, it can be further employed to investigate the other possible SBO scenarios and to study the scaling distortions in the ATLAS. (authors)« less

  19. Schwannome benin primitif retrovesical: une tumeur très rare à propos d'un cas

    PubMed Central

    Beddouche, Ali; Fahsi, Othemane; Kallat, Adil; El Bote, Hicham; Ziani, Idriss; El Sayegh, Hachem; Iken, Ali; Benslimane, Lounis; Nouini, Yassine

    2016-01-01

    Le schwannome est une tumeur le plus souvent bénigne, d'origine nerveuse se développant à partir des cellules de la gaine de Schwann. C'est une tumeur très rare tant par sa fréquence que par sa localisation rétrovésicale. L'examen anatomopathologique et immunohistochimique confirme le type histologique ainsi que le caractère bénin ou malin du schwannome. En raison des récidives, et du risque de transformation maligne, l'exérèse doit être complète. Nous rapportons le cas d'un patient âgé de 39 ans, admis pour une douleur pelvienne chronique à type de pesanteur, des signes irritatifs du bas appareil urinaire, et des troubles de transit. L'imagerie (échographie, TDM, IRM) a révélé la présence d'une masse pelvienne rétrovésicale, à paroi fine, latéralisée à gauche, mesurant 68x70x70 mm, exerçant un effet de masse sur la vessie et le sigmoïde. L'intervention chirurgicale menée par une laparotomie médiane a permis l'exérèse d'une masse retrovésicale bien encapsulée. L'examen anatomopathologique et immunohistochimique ont conclu à un schwannome bénin. La récidive et la transformation maligne bien que rare après chirurgie impose une surveillance post opératoire clinique et tomodensitométrique annuelle. PMID:27217902

  20. Phylogenetic diversity and spatial distribution of the microbial community associated with the Caribbean deep-water sponge Polymastia cf. corticata by 16S rRNA, aprA, and amoA gene analysis.

    PubMed

    Meyer, Birte; Kuever, Jan

    2008-08-01

    Denaturing gradient gel electrophoresis (DGGE)-based analyses of 16S rRNA, aprA, and amoA genes demonstrated that a phylogenetically diverse and complex microbial community was associated with the Caribbean deep-water sponge Polymastia cf. corticata Ridley and Dendy, 1887. From the 38 archaeal and bacterial 16S rRNA phylotypes identified, 53% branched into the sponge-specific, monophyletic sequence clusters determined by previous studies (considering predominantly shallow-water sponge species), whereas 26% appeared to be P. cf. corticata specifically associated microorganisms ("specialists"); 21% of the phylotypes were confirmed to represent seawater- and sediment-derived proteobacterial species ("contaminants") acquired by filtration processes from the host environment. Consistently, the aprA and amoA gene-based analyses indicated the presence of environmentally derived sulfur- and ammonia-oxidizers besides putative sponge-specific sulfur-oxidizing Gammaproteobacteria and Alphaproteobacteria and a sulfate-reducing archaeon. A sponge-specific, endosymbiotic sulfur cycle as described for marine oligochaetes is proposed to be also present in P. cf. corticata. Overall, the results of this work support the recent studies that demonstrated the sponge species specificity of the associated microbial community while the biogeography of the host collection site has only a minor influence on the composition. In P. cf. corticata, the specificity of the sponge-microbe associations is even extended to the spatial distribution of the microorganisms within the sponge body; distinct bacterial populations were associated with the different tissue sections, papillae, outer and inner cortex, and choanosome. The local distribution of a phylotype within P. cf. corticata correlated with its (1) phylogenetic affiliation, (2) classification as sponge-specific or nonspecifically associated microorganism, and (3) potential ecological role in the host sponge.

  1. The Role of Novel Substituted Diindolyl Methane Analogues in the Treatment of Triple-Negative and ErbB2-Positive Breast Cancer

    DTIC Science & Technology

    2015-05-01

    studies show differential expression of NR4A receptors [181,182] and studies on dopamine neurons showed that in the ventral tegmental area, haloperidol ...Blanchet, D. Levesque, Haloperidol -induced striatal Nur77 expression in a non-human primate model of tardive dyskinesia, Eur. J. Neurosci. 38 (2013

  2. [A study on English loan words in French plastic surgery].

    PubMed

    Hansson, E; Tegelberg, E

    2014-10-01

    The French language is less and less used as an international scientific language and many French researchers publish their work in English. Nowadays, Annales de Chirurgie Plastique Esthétique is the only international plastic surgical journal published completely in French. The use of English loan words in French plastic surgery has never been studied. The aim of this study was to describe the frequency and types of English loan words in French plastic surgery. A corpus consisting of all the articles in a number of Annales de Chirurgie Plastique Esthethique, chosen by default, was created. The frequency of English loan words was calculated and the types of words were analysed. The corpus contains 367 (0.8%) English loan words. Most of them are non-integrated loan words and calques. The majority of the plastic surgical loan words describe surgical techniques. The French plastic surgical language seems to be influenced by English. The usage of loan words does not always follow the recommendations and the usage is sometimes ambiguous. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Predictors of exclusive breastfeeding: observations from the Alberta pregnancy outcomes and nutrition (APrON) study.

    PubMed

    Jessri, Mahsa; Farmer, Anna P; Maximova, Katerina; Willows, Noreen D; Bell, Rhonda C

    2013-05-16

    Despite growing evidence that supports the importance of 6-month exclusive breastfeeding, few Canadian mothers adhere to this, and early weaning onto solids is a common practice. This study assessed infant feeding transitions during the first 6 months postpartum and factors that predicted exclusive breastfeeding to 3 and 6 months. This prospective cohort study was part of the Alberta Pregnancy Outcomes and Nutrition study (APrON). From an initial sample of 600 pregnant women recruited from Edmonton and Calgary, 402 mothers provided complete details at 3 months postpartum; 300 stayed on to provide information at 6 months postpartum. During pregnancy and at 3 and 6 months postpartum, data on maternal and infant socio-demographic, behavior, and feeding were collected. Even though there was a high rate of "ever having breastfed" (98.6%), exclusive breastfeeding rates for 3 and 6 months were 54.0% and 15.3%, respectively. After controlling for potential confounders, the study showed that mothers who held post-graduate university degrees were 3.76 times more likely to breastfeed exclusively for 6 months than those without a university degree (95% CI: 1.30-10.92; p = 0.015). In addition, mother of previous children were more likely to breastfeed exclusively for 6 months (OR: 2.21, 95% CI: 1.08-4.52; p = 0.031). Mothers who were in the highest quartile of the Iowa Infant Feeding Attitude Score were 4.29 and 5.40 times more likely to breastfeed exclusively for 3 months (95% CI: 1.31-14.08; p-trend < 0.001) and 6 months (95% CI: 2.75-10.60; P-trend < 0.001), respectively. The 6-month exclusive breastfeeding rate in Alberta is considerably below national and international breastfeeding recommendations. Professional advice that focuses on prenatal maternal knowledge, attitudes, and misperceptions may promote adherence to World Health Organization breastfeeding guidelines. Knowing that exclusive breastfeeding is less likely to take place among lower

  4. L'endométriose de la paroi abdominale: à propos d'un cas rare

    PubMed Central

    Jayi, Sofia; Laadioui, Meriem; Bouguern, Hakima; Chaara, Hikmat; Melhouf, Aabdelilah

    2013-01-01

    L'endométriose de la paroi est une entité clinique rare, dont la physiopathologie demeure imprécise. Elle survient le plus souvent après une intervention chirurgicale gynécologique ou obstétricale. Nous rapportons le cas d'une patiente présentant une douleur cyclique, au niveau de la cicatrice de césarienne. Avec à l'examen clinique une masse de 3 cm localisée au niveau de la fosse iliaque droite. L'échographie-doppler a objectivé une image d'allure tissulaire, polylobée, à vascularisation centrale, mesurant 32/16 mm, évoquent une masse endométriosique ou une tumeur des parties molles. D'où la décision d'excision de la lésion, au cours de laquelle on a découvert une masse dure de 3/2 cm, en sous aponévrotique accolée au muscle grand droit de l'abdomen. L'étude anatomopathologique a confirmé le diagnostic d'endométriose pariétale. Les suites postopératoires étaient simples avec un recul de 2 ans et demie sans récidive de la masse ni de la douleur. A travers notre cas, nous insisterons sur les caractéristiques de cette pathologie notamment pronostic, ce qui permettra au praticien de comprendre l'intérêt du diagnostic et prise en charge précoce de cette entité - pour laquelle on ne pense jamais assez devant une masse pariétale - et de sa prévention au cours de chaque chirurgie gynécologique ou obstétricale. PMID:24171068

  5. The Convergent and Divergent Validity of the Matson Evaluation of Drug Side-Effects (MEDS) and the Dyskinesia Identification System: Condensed User Scale (DISCUS)

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Fodstad, Jill C.; Rivet, Tessa T.

    2008-01-01

    Background: Medication side-effects such as tardive dyskinesia (TD) are known to occur in individuals with a history of psychotropic drug use. This study aimed to contribute to the development of measures for assessing TD by examining the validity of the "Matson Evaluation of Drug Side-effects" (MEDS) with the "Dyskinesia…

  6. A Study of Health Record Control at Reynolds Army Hospital, Fort Sill, Oklahoma

    DTIC Science & Technology

    1979-04-01

    other medical and surgical procedures appear on the walls of Paleolithic caverns of Spain that date back to about 25,000 B.C.1 Although these archaic...record revealed that they were more careful in taking medications, made improvements in their diets , stopped smoking and had fewer worries about their...Pod 19 Mar TMC 3 30 Apr Surg 6 Apr RAH 29 Apr Eye 27 Apr Audio Cl 27 Apr Hosp 27 Nov Diet Cl 23 Apr F.P. 18 Apr Ortho/Pod 30 Apr Pod 26 Apr RAN 30 Apr

  7. Urinary bisphenol A is associated with dysregulation of HPA-axis function in pregnant women: Findings from the APrON cohort study.

    PubMed

    Giesbrecht, Gerald F; Liu, Jiaying; Ejaredar, Maede; Dewey, Deborah; Letourneau, Nicole; Campbell, Tavis; Martin, Jonathan W

    2016-11-01

    Bisphenol A (BPA) is associated with dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity in rodents, but evidence in humans is lacking. To determine whether BPA exposure during pregnancy is associated with dysregulation of the HPA-axis, we examined the association between urinary BPA concentrations and diurnal salivary cortisol in pregnant women. Secondary analyses investigated whether the association between BPA and cortisol was dependent on fetal sex. Diurnal salivary cortisol and urinary BPA were collected during pregnancy from 174 women in a longitudinal cohort study, the Alberta Pregnancy Outcomes and Nutrition (APrON) study. Associations between BPA and daytime cortisol and the cortisol awakening response (CAR) were estimated using mixed models after adjusting for covariates. Higher concentrations of total BPA uncorrected for urinary creatinine were associated with dysregulation of the daytime cortisol pattern, including reduced cortisol at waking, β=-.055, 95% CI (-.100, -.010) and a flatter daytime pattern, β=.014, 95% CI (.006, .022) and β=-.0007 95% CI (-.001, -.0002) for the linear and quadratic slopes, respectively. Effect sizes in creatinine corrected BPA models were slightly smaller. None of the interactions between fetal sex and BPA were significant (all 95% CI's include zero). These findings provide the first human evidence suggesting that BPA exposure is associated with dysregulation of HPA-axis function during pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Dopamine depleters in the treatment of hyperkinetic movement disorders.

    PubMed

    Jankovic, Joseph

    2016-12-01

    Abnormal involuntary movements often improve in response to anti-dopaminergic drugs. In contrast to classic neuroleptics that block dopamine receptors, drugs that deplete presynaptic dopamine by blocking vesicular monoamine transporter type 2 (VMAT2) seem to be safer and have little or no risk of tardive dyskinesia. This is one reason why there has been a recent emergence of novel VMAT2 inhibitors. Areas covered: Since the approval of tetrabenazine, the classic VMAT2 inhibitor, in the treatment of chorea associated with Huntington disease (HD), other VMAT2 inhibitors (e.g. deutetrabenazine and valbenazine) have been studied in the treatment of HD-related chorea, tardive dyskinesia and tics associated with Tourette syndrome. This review, based largely on a detailed search of PubMed, will summarize the pharmacology and clinical experience with the various VMAT2 inhibitors. Expert commentary: Because of differences in pharmacology and pharmacokinetics these new VMAT2 inhibitors promise to be at least as effective as tetrabenazine but with a lower risk of adverse effects, such as sedation, insomnia, depression, parkinsonism, and akathisia.

  9. [A case of respiratory dyskinesia due to clebopride malate].

    PubMed

    Kawasaki, H; Yamamoto, M; Okayasu, H; Wakayama, Y

    1991-08-01

    Clebopride malate is therapeutically used for the treatment of peptic ulcer. This drug has potent antidopaminergic activity that causes acute dystonic reaction, parkinsonism and tardive dyskinesia as adverse effects. Here, we have reported an 86-year-old man who developed abnormal involuntary movement of respiratory muscles and lower limb muscles after this drug had been given for four months. This involuntary movement appeared spontaneously at resting state and disappeared during sleep. Surface EMG demonstrated a synchronous grouping discharge in m. orbicularis oris, m. sternocleidomastoideus and m. interstales which synchronized with diaphragmatic movement on cinefluorography. Involuntary movement of the lower limbs was synchronous bilaterally and had little relationship with diaphragmatic movement. This involuntary movement was irregular not only in rhythm but also in duration. According to this irregular nature, we diagnosed this involuntary movement as respiratory dyskinesia with limb dyskinesia that belongs to tardive dyskinesia. After cessation of clebopride malate limb dyskinesia disappeared rapidly and respiratory dyskinesia markedly decreased. We emphasize that respiratory dyskinesia should be differentiated from psychogenic hyperventilation as easily misdiagnosed on initial examination.

  10. Predictors of exclusive breastfeeding: observations from the Alberta pregnancy outcomes and nutrition (APrON) study

    PubMed Central

    2013-01-01

    Background Despite growing evidence that supports the importance of 6-month exclusive breastfeeding, few Canadian mothers adhere to this, and early weaning onto solids is a common practice. This study assessed infant feeding transitions during the first 6 months postpartum and factors that predicted exclusive breastfeeding to 3 and 6 months. Methods This prospective cohort study was part of the Alberta Pregnancy Outcomes and Nutrition study (APrON). From an initial sample of 600 pregnant women recruited from Edmonton and Calgary, 402 mothers provided complete details at 3 months postpartum; 300 stayed on to provide information at 6 months postpartum. During pregnancy and at 3 and 6 months postpartum, data on maternal and infant socio-demographic, behavior, and feeding were collected. Results Even though there was a high rate of “ever having breastfed” (98.6%), exclusive breastfeeding rates for 3 and 6 months were 54.0% and 15.3%, respectively. After controlling for potential confounders, the study showed that mothers who held post-graduate university degrees were 3.76 times more likely to breastfeed exclusively for 6 months than those without a university degree (95% CI: 1.30-10.92; p = 0.015). In addition, mother of previous children were more likely to breastfeed exclusively for 6 months (OR: 2.21, 95% CI: 1.08-4.52; p = 0.031). Mothers who were in the highest quartile of the Iowa Infant Feeding Attitude Score were 4.29 and 5.40 times more likely to breastfeed exclusively for 3 months (95% CI: 1.31-14.08; p-trend < 0.001) and 6 months (95% CI: 2.75-10.60; P-trend < 0.001), respectively. Conclusions The 6-month exclusive breastfeeding rate in Alberta is considerably below national and international breastfeeding recommendations. Professional advice that focuses on prenatal maternal knowledge, attitudes, and misperceptions may promote adherence to World Health Organization breastfeeding guidelines. Knowing that exclusive breastfeeding

  11. Impaired epithelial differentiation of induced pluripotent stem cells from ectodermal dysplasia-related patients is rescued by the small compound APR-246/PRIMA-1MET.

    PubMed

    Shalom-Feuerstein, Ruby; Serror, Laura; Aberdam, Edith; Müller, Franz-Josef; van Bokhoven, Hans; Wiman, Klas G; Zhou, Huiqing; Aberdam, Daniel; Petit, Isabelle

    2013-02-05

    Ectodermal dysplasia is a group of congenital syndromes affecting a variety of ectodermal derivatives. Among them, ectrodactyly, ectodermal dysplasia, and cleft lip/palate (EEC) syndrome is caused by single point mutations in the p63 gene, which controls epidermal development and homeostasis. Phenotypic defects of the EEC syndrome include skin defects and limbal stem-cell deficiency. In this study, we designed a unique cellular model that recapitulated major embryonic defects related to EEC. Fibroblasts from healthy donors and EEC patients carrying two different point mutations in the DNA binding domain of p63 were reprogrammed into induced pluripotent stem cell (iPSC) lines. EEC-iPSC from both patients showed early ectodermal commitment into K18(+) cells but failed to further differentiate into K14(+) cells (epidermis/limbus) or K3/K12(+) cells (corneal epithelium). APR-246 (PRIMA-1(MET)), a small compound that restores functionality of mutant p53 in human tumor cells, could revert corneal epithelial lineage commitment and reinstate a normal p63-related signaling pathway. This study illustrates the relevance of iPSC for p63 related disorders and paves the way for future therapy of EEC.

  12. Evolution post-opératoire des séquelles de tuberculose pulmonaire chez les séropositifs VIH

    PubMed Central

    Grégoire, Ayegnon Kouakou; Flavien, Kendja Hypolite; Raphaël, Ouédé; Démine, Blaise; Christophe, Ménéas Gueu; Marie, Ano Kounangui; Hervé, Yangni-Angaté Koffi; Yves, Tanauh

    2014-01-01

    Cette étude rapporte les aspects cliniques et évolutifs des séquelles pulmonaires tuberculeuses (SPT) opérées chez les séropositifs (VIH+). Il s'agit d'une étude prospective transversale réalisée entre Novembre 2005 et Octobre 2012. Elle a porté sur 20 patients VIH+, ayant dans leurs antécédents, une tuberculose pulmonaire (TP) traitée et déclarée guérie, et admise dans ladite période pour une chirurgie de la SPT secondaire. Une enquête sérologique VIH a été réalisée systématiquement au cours du bilan pré-opératoire. Le diagnostic pré-opératoire de la SPT, la mortalité, les complications post- opératoires (CPOP), le séjour hospitalier, le suivi à moyen terme des STP opérées ont été évalués. Les séropositifs étaient VIH1+ (n = 12; 60%), VIH1&2+ (n = 4; 20%) et VIH2+ (n = 4; 20%). La durée moyenne d’évolution des STP était de 26,22 ± 21,3 mois. Les STP étaient les pyothorax ou pleurésies enkystées (n = 16; 80%), le poumon détruit (n = 2;10%) et les dilatations de bronches (n = 2;10%). Les VIH+ ne présentaient pas d'aspergillome pulmonaire. Le séjour hospitalier moyen était 13,1 ± 10,2 jours. Le suivi total était de 82 patients-année avec une moyenne de suivi de 4,2 ± 2,3 ans (extrêmes: 1 et 7 ans). Le taux de mortalité à court et moyen terme était nul. Aucun décès post-opératoire immédiat n'a été noté. Les CPOP immédiates étaient les bullages prolongés chez 75% des immunodéprimés. Les CPOP tardives (n = 3) étaient un syndrome restrictif pulmonaire, un pyothorax persistant et une pachypleurite résiduelle restrictive. A court terme, le taux de guérison radiologique était de 80% (n = 16). PMID:24932331

  13. Complete Protection against Influenza Virus H1N1 Strain A/PR/8/34 Challenge in Mice Immunized with Non-Adjuvanted Novirhabdovirus Vaccines

    PubMed Central

    Rouxel, Ronan N.; Mérour, Emilie; Biacchesi, Stéphane; Brémont, Michel

    2016-01-01

    Novirhabdoviruses like Viral Hemorrhagic Septicemia Virus (VHSV) and Infectious Hematopoietic Necrosis Virus (IHNV) are fish-infecting Rhabdoviruses belonging to the Mononegavirales order. By reverse genetics, we previously showed that a recombinant VHSV expressing the West Nile Virus (WNV) E glycoprotein could serve as a vaccine platform against WNV. In the current study, we aimed to evaluate the potential of the Novirhabdovirus platform as a vaccine against influenza virus. Recombinant Novirhabdoviruses, rVHSV-HA and rIHNV-HA, expressing at the viral surface the hemagglutinin HA ectodomain were generated and used to immunized mice. We showed that mice immunized with either, rVHSV-HA or rIHNV-HA, elicited a strong neutralizing antibody response against influenza virus. A complete protection was conferred to the immunized mice when challenged with a lethal dose of influenza H1N1 A/PR/8/34 virus. Furthermore we showed that although acting as inert antigen in mice, since naturally inactivated over 20°C, mice immunized with rVHSV-HA or rIHNV-HA in the absence of adjuvant were also completely protected from a lethal challenge. Novirhabdoviruses platform are of particular interest as vaccines for mammals since they are cost effective to produce, relatively easy to generate and very effective to protect immunized animals. PMID:27711176

  14. p53 Reactivation by PRIMA-1(Met) (APR-246) sensitises (V600E/K)BRAF melanoma to vemurafenib.

    PubMed

    Krayem, Mohammad; Journe, Fabrice; Wiedig, Murielle; Morandini, Renato; Najem, Ahmad; Salès, François; van Kempen, Leon C; Sibille, Catherine; Awada, Ahmad; Marine, Jean-Christophe; Ghanem, Ghanem

    2016-03-01

    Intrinsic and acquired resistance of metastatic melanoma to (V600E/K)BRAF and/or MEK inhibitors, which is often caused by activation of the PI3K/AKT survival pathway, represents a major clinical challenge. Given that p53 is capable of antagonising PI3K/AKT activation we hypothesised that pharmacological restoration of p53 activity may increase the sensitivity of BRAF-mutant melanoma to MAPK-targeted therapy and eventually delay and/or prevent acquisition of drug resistance. To test this possibility we exposed a panel of vemurafenib-sensitive and resistant (innate and acquired) (V600E/K)BRAF melanomas to a (V600E/K)BRAF inhibitor (vemurafenib) alone or in combination with a direct p53 activator (PRIMA-1(Met)/APR-246). Strikingly, PRIMA-1(Met) synergised with vemurafenib to induce apoptosis and suppress proliferation of (V600E/K)BRAF melanoma cells in vitro and to inhibit tumour growth in vivo. Importantly, this drug combination decreased the viability of both vemurafenib-sensitive and resistant melanoma cells irrespectively of the TP53 status. Notably, p53 reactivation was invariably accompanied by PI3K/AKT pathway inhibition, the activity of which was found as a dominant resistance mechanism to BRAF inhibition in our lines. From all various combinatorial modalities tested, targeting the MAPK and PI3K signalling pathways through p53 reactivation or not, the PRIMA-1(Met)/vemurafenib combination was the most cytotoxic. We conclude that PRIMA-1(Met) through its ability to directly reactivate p53 regardless of the mechanism causing its deactivation, and thereby dampen PI3K signalling, sensitises (V600E/K)BRAF-positive melanoma to BRAF inhibitors. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Use of micronutrient supplements among pregnant women in Alberta: results from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort.

    PubMed

    Gómez, Mariel Fajer; Field, Catherine J; Olstad, Dana Lee; Loehr, Sarah; Ramage, Stephanie; McCargar, Linda J

    2015-10-01

    Maternal nutrient intake in the prenatal period is an important determinant of fetal growth and development and supports maternal health. Many women, however, fail to meet their prenatal nutrient requirements through diet alone and are therefore advised to consume nutrient supplements. The purpose of this study was to describe the use of natural health products (NHP) by pregnant women in each trimester of pregnancy. Women (n = 599) participating in the first cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study completed an interviewer-administered supplement intake questionnaire during each trimester of pregnancy. NHP use was high, with >90% taking multivitamin/mineral supplements, and nearly half taking at least one additional single-nutrient supplement. Compliance with supplementation guidelines was high for folic acid (>90%), vitamin D (∼70%) and calcium (∼80%), but low for iron (<30%) and for all four nutrients together (≤11%). On average, women met or exceeded the recommended dietary allowance for folic acid, vitamin D and iron from NHPs alone, with median daily intakes of 1000 μg, 400 IU and 27 mg, respectively. The median calcium intake was 250 mg d(-1) . Up to 26% of women exceeded the tolerable upper intake level for folic acid and up to 19% did so for iron at some point of their pregnancy. Findings highlight the need to consider both dietary and supplemental sources of micronutrients when assessing the nutrient intakes of pregnant women. © 2013 John Wiley & Sons Ltd.

  16. Do patients requiring a multivisceral resection for rectal cancer have worse oncologic outcomes than patients undergoing only abdominoperineal resection?

    PubMed

    Dosokey, Eslam M G; Brady, Justin T; Neupane, Ruel; Jabir, Murad A; Stein, Sharon L; Reynolds, Harry L; Delaney, Conor P; Steele, Scott R

    2017-09-01

    Abdominoperineal Resection (APR) remains an important option for patients with advanced rectal cancer though some may require multivisceral resection (MVR) in addition to APR. We hypothesized that oncological outcomes would be worse with MVR. A retrospective review from 2006 to 2015 of 161 patients undergoing APR or MVR for rectal cancer, of whom 118 underwent curative APR or APR with MVR. Perioperative, oncologic and survival metrics were evaluated. There were 82 patients who underwent APR and 36 who underwent MVR. Surgical approach and incidence of complications were similar (All P > 0.05). There was 1 local recurrence in each of the APR and MVR groups at a mean follow-up of 34 and 32 months, respectively. Distant recurrences occurred in 3 APR patients and 4 MVR patients. APR and APR with MVR can be performed with comparable morbidity and oncologic outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Les fractures luxations du cotyle: prise en charge et pronostic à long terme; étude rétrospective portant sur 40 cas

    PubMed Central

    Chagou, Aniss; Hmouri, Ismail; Rhanim, Abdelkarim; Lahlou, Abdou; Berrada, Mohammed Saleh; Yaacoubi, Moradh

    2014-01-01

    Les fractures luxations du cotyle sont le plus souvent dues à des traumatismes de haute énergie. Elles constituent une urgence thérapeutique, l'association de la luxation à une fracture du cotyle fait apparaître la question du choix thérapeutique entre traitement orthopédique et traitement médical. L'objectif de l’étude est de mettre le point sur l'aspect thérapeutique dans ces lésions mais aussi leurs pronostics à long terme. Nous rapportons une étude rétrospective portant sur 40 cas colligés au service d'orthopédie du centre hospitalier universitaire de Rabat. Nous avons évalué les résultats de notre prise en charge mais aussi le pronostic à court et à long terme. Dans notre série, vingt cinq patients ont bénéficié d'un traitement orthopédique alors que les quinze restants ont été opérés, la voie d'abord la plus utilisée est la voie postérieure. Les résultats fonctionnels ont été évalués, après un recul de 3 à 8 ans, selon la cotation de Merle d'Aubigné. Nous avons obtenu 90% de résultats satisfaisants. La comparaison de nos résultats à ceux de la littérature montre que le résultat des traitements orthopédiques et chirurgicaux dépend essentiellement du type de fracture. Le pronostic à long terme reste imprévisible. La survenue des complications tardives telle que la nécrose céphalique et de l'arthrose reste toujours imprévisible, ce qui impose un suivi régulier et prolongé des patients. PMID:25722763

  18. Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases.

    PubMed

    Healy, David; Le Noury, Joanna; Mangin, Derelie

    2018-05-01

    To investigate clinical reports of post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS) and enduring sexual dysfunction following isotretinoin. Data from RxISK.org, a global adverse event reporting website, have been used to establish the clinical features, demographic details and clinical trajectories of syndromes of persistent sexual difficulties following three superficially different treatment modalities.RESULTSWe report on 300 cases of enduring sexual dysfunction from 37 countries following 14 different drugs comprised of serotonin reuptake inhibiting antidepressants, 5α-reductase inhibitors and isotretinoin. While reports of certain issues were unique to the antidepressants, such as the onset of premature ejaculation and persistent genital arousal disorder (PGAD), there was also a significant overlap in symptom profile between the drug groups, with common features including genital anaesthesia, pleasureless or weak orgasm, loss of libido and impotence. Secondary consequences included relationship breakdown and impaired quality of life.CONCLUSIONSThese data point to a legacy syndrome or syndromes comprising a range of disturbances to sexual function. More detailed studies will require developments in coding systems that recognise the condition(s). Further exploration of these tardive sexual syndromes may yield greater understanding of tardive syndromes in general.

  19. Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases

    PubMed Central

    Healy, David; Le Noury, Joanna; Mangin, Derelie

    2018-01-01

    OBJECTIVE: To investigate clinical reports of post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS) and enduring sexual dysfunction following isotretinoin. METHODS: Data from RxISK.org, a global adverse event reporting website, have been used to establish the clinical features, demographic details and clinical trajectories of syndromes of persistent sexual difficulties following three superficially different treatment modalities. RESULTS We report on 300 cases of enduring sexual dysfunction from 37 countries following 14 different drugs comprised of serotonin reuptake inhibiting antidepressants, 5α-reductase inhibitors and isotretinoin. While reports of certain issues were unique to the antidepressants, such as the onset of premature ejaculation and persistent genital arousal disorder (PGAD), there was also a significant overlap in symptom profile between the drug groups, with common features including genital anaesthesia, pleasureless or weak orgasm, loss of libido and impotence. Secondary consequences included relationship breakdown and impaired quality of life. CONCLUSIONS These data point to a legacy syndrome or syndromes comprising a range of disturbances to sexual function. More detailed studies will require developments in coding systems that recognise the condition(s). Further exploration of these tardive sexual syndromes may yield greater understanding of tardive syndromes in general. PMID:29733030

  20. Cystostomie percutanée à la pince de Kelly: indications, technique et résultats

    PubMed Central

    Diabaté, Ibrahima; Ouédraogo, Bouréima; Sow, Ibrahima; Bâ, Aliou

    2015-01-01

    Introduction La dérivation urinaire sus-pubienne est pratiquée dans différentes circonstances. Cette étude vise à décrire la technique de cystostomie percutanée (CPC) pratiquée à l'aide d'une pince de Kelly pour la pose d'une sonde de Foley, à définir les indications de cette technique et à rapporter les résultats. Méthodes Du 1er janvier 2005 au 31 décembre 2014, il a été réalisé 194 CPC à la pince de Kelly dans notre service, en urgence, sous anesthésie locale, chez des patients en rétention vésicale. Cette technique, dérivée de la cystostomie par ponction au trocart vise à placer dans la vessie une sonde de Foley après incision cutanée et aponévrotique (de 1 cm sur la ligne médiane, à 1,5 - 2 cm au-dessus de la symphyse pubienne) et la ponction vésicale à la pince de Kelly à travers cette incision. Résultats Les 194 patients étaient tous de sexe masculin, âgés en moyenne de 50 ans ± 21 (extrêmes de 17 ans et 86 ans). Les pathologies à l'origine des rétentions vésicales étaient: les rétrécissements urétraux (n=119), les hypertrophies bénignes de la prostate (n=47), les cancers de prostate (n=21), les traumatismes de l'urètre (n=7). Tous les patients ont été opérés avec succès par cette méthode et les suites ont été simples. Le temps de réalisation était de 6 minutes ± 1. Les sondes de Foley mises en place étaient de charrière 16 (n=59), charrière 18 (n=116) et charrière 20 (n=19). La cicatrisation du trajet de la CPC après l'ablation de la sonde de Foley n'a posée aucun problème chez 146 patients suivis, les 48 autres ayant été perdus de vue. Conclusion La CPC à la pince de Kelly est une technique simple, rapide et pas onéreuse. Ses indications sont les mêmes que pour toute CPC et elle représente une alternative à la cystostomie par chirurgie ouverte. PMID:26893798

  1. Adenomyose utérine, étude clinique et thérapeutique: à propos de 87 cas

    PubMed Central

    Kdous, Moez; Ferchiou, Monia; Zhioua, Fethi

    2015-01-01

    Le but de notre étude est l'analyse des différents aspects épidémiologiques, cliniques, paracliniques et thérapeutiques de l'adénomyose. Il s'agit d'une étude rétrospective sur 87 patientes ayant bénéficié d'une hystérectomie pour des raisons diverses (hors prolapsus) entre le 1er janvier 2000 et 31 décembre 2006 et dont l’étude histologique de la pièce opératoire a révélé la présence d'adénomyose. 586 hystérectomies (hors prolapsus) ont été réalisées pendant la même période d’étude, soit une fréquence de l'adénomyose sur pièce opératoire de 14.85%. L'age moyen de nos patientes est de 43.97 ans (extrêmes: 26-64 ans). 29.88% d'entres-elles sont ménopausées et 41.37% avaient des antécédents de traumatisme utérin. La symptomatologie a été dominée par les ménometrorragies (82.77%) et les douleurs pelviennes (71.22%). Le diagnostic préopératoire a été suspecté sur les données de l'hystéroscopie dans 63.22% des cas, de l'hystérographie dans 58.46% des cas et de l’échographie transvaginale dans 40.5% des cas. Une chirurgie radicale a été indiquée de première intention dans 57 cas, après échec du traitement médical dans 16 cas et après échec d'une réduction endométriale dans 14 cas. L'analyse histologique des pièces d'hystérectomie trouve des myomes associés dans 32.18% des cas, une hyperplasie de l'endomètre dans 13.79%, des polypes dans 5.74% et une atrophie de l'endomètre dans 3.44%. L'adénomyose, maladie énigmatique, échappe toujours à une stratégie thérapeutique bien codifiée, et demeure étroitement liée à l'hystérectomie. Son dépistage chez des femmes de plus en plus jeunes et à des stades moins avancés pourrait éviter l’évolution systématique vers les traitements radicaux. PMID:26834926

  2. Metabolic syndrome and adverse clinical outcomes in patients with bipolar disorder.

    PubMed

    Bai, Ya-Mei; Li, Cheng-Ta; Tsai, Shih-Jen; Tu, Pei-Chi; Chen, Mu-Hong; Su, Tung-Ping

    2016-12-15

    Metabolic syndrome (MetS) is highly prevalent among patients with bipolar disorder. MetS may cause complications in the brain, but studies investigating MetS-associated clinical psychiatric outcomes remain scant. We enrolled clinically stable outpatients with bipolar disorder aged 18-65 years and performed anthropometric and fasting biochemical assessments to investigate MetS prevalence. We then performed clinical assessments by using the Young Mania Rating Scale for manic symptoms, the Montgomery-Åsberg Depression Rating Scale for depressive symptoms, the Positive and Negative Symptom Scale for psychotic symptoms, the Involuntary Movement Scale for tardive dyskinesia, the Barnes Akathisia Rating Scale for akathisia, the Udvalg for Kliniske Undersogelser for general side effects, the Schedule for Assessment of Insight for insight, the Global Assessment of Functioning scale for global functioning, and the Wisconsin Card Sorting Test (WCST) for cognitive executive function. In total, 143 patients were enrolled and had a MetS prevalence of 29.4%. The patients treated with atypical antipsychotics plus mood stabilizers (36.3%) and atypical antipsychotics alone (36.0%) had a significantly higher prevalence of MetS than did those treated with mood stabilizers alone (10.5%; p = 0.012). According to multivariate regression analyses adjusted for age, sex, smoking status, bipolar disorder subtype (I or II), pharmacological treatment duration, and psychiatric medication, compared with patients without MetS, those with MetS had significantly more previous hospitalizations (p = 0.036), severer tardive dyskinesia (p = 0.030), poorer insight (p = 0.036), poorer global function (p = 0.046), and more impaired executive function (conceptual level response on the WCST; p = 0.042). Our results indicated that patients with comorbid bipolar disorder and MetS have more adverse clinical outcomes than those without, with more hospitalizations, severer tardive

  3. [Evaluation of the appropriateness of hospital admissions using the iso-gravity classification systems APR-DRG and Disease Staging and the Italian version of Appropriateness Evaluation Protocol (AEP)].

    PubMed

    D'Andrea, G; Capalbo, G; Volpe, M; Marchetti, M; Vicentini, F; Capelli, G; Cambieri, A; Cicchetti, A; Ricciardi, G; Catananti, C

    2006-01-01

    Our main purpose was to evaluate the organizational appropriateness of admissions made in a university hospital, by comparing two iso-gravity classification systems, APR-DRG and Disease Staging, with the Italian version of AEP (PRUO). Our analysis focused on admissions made in 2001, related to specific Diagnosis Related Groups (DRGs), which, according an Italian Law, would be considered at high risk of inappropriateness, if treated as ordinary admissions. The results obtained by using the 2 classification systems did not show statistically significant differences with respect to the total number of admissions. On the other hand, some DRGs showed statistically significant differences due to different algorithms of attribution of the severity levels used by the two systems. For almost all of the DRGs studied, the AEP-based analysis of a sample of medical records showed an higher number of inappropriate admissions in comparison with the number expected by iso-gravity classification methods. The difference is possibly due to the percentage limits of tolerability fixed by the Law for each DRG. Therefore, the authors suggest an integrated use of the two methods to evaluate organizational appropriateness of hospital admissions.

  4. Manual for the Extrapyramidal Symptom Rating Scale (ESRS).

    PubMed

    Chouinard, Guy; Margolese, Howard C

    2005-07-15

    The Extrapyramidal Symptom Rating Scale (ESRS) was developed to assess four types of drug-induced movement disorders (DIMD): Parkinsonism, akathisia, dystonia, and tardive dyskinesia (TD). Comprehensive ESRS definitions and basic instructions are given. Factor analysis provided six ESRS factors: 1) hypokinetic Parkinsonism; 2) orofacial dyskinesia; 3) trunk/limb dyskinesia; 4) akathisia; 5) tremor; and 6) tardive dystonia. Two pivotal studies found high inter-rater reliability correlations in both antipsychotic-induced movement disorders and idiopathic Parkinson disease. For inter-rater reliability and certification of raters, >or=80% of item ratings of the complete scale should be +/-1 point of expert ratings and >or=70% of ratings on individual items of each ESRS subscale should be +/-1 point of expert ratings. During a cross-scale comparison, AIMS and ESRS were found to have a 96% (359/374) agreement between TD-defined cases by DSM-IV TD criteria. Two recent international studies using the ESRS included over 3000 patients worldwide and showed an incidence of TD ranging from 10.2% (2000) to 12% (1998). ESRS specificity was investigated through two different approaches, path analyses and ANCOVA PANSS factors changes, which found that ESRS measurement of drug-induced EPS is valid and discriminative from psychiatric symptoms.

  5. Prevalence of neuroleptic-induced movement disorders in chronic schizophrenia inpatients.

    PubMed

    Janno, Sven; Holi, Matti; Tuisku, Katinka; Wahlbeck, Kristian

    2004-01-01

    Since most of the world's schizophrenia patients are treated with conventional antipsychotics, the authors evaluated various methods for establishing the prevalence of neuroleptic-induced movement disorders in these patients. DSM-IV criteria and established score thresholds on a movement disorder rating scale were used to identify cases of neuroleptic-induced movement disorder in a representative Estonian patient sample of 99 chronic institutionalized schizophrenia patients, 18-65 years old, treated with conventional neuroleptics (79.8%) or clozapine (20.2%). Neuroleptic-induced movement disorders according to DSM-IV criteria were found in 61.6% of the group: 31.3% had neuroleptic-induced akathisia, 23.2% had neuroleptic-induced parkinsonism, and 32.3% had neuroleptic-induced tardive dyskinesia. Prevalence rates for akathisia and tardive dyskinesia were similar when either DSM-IV criteria or rating scale scores were used, but the prevalence rate for parkinsonism was much lower per DSM-IV criteria than according to rating scale score. Nearly two-thirds of chronic schizophrenia patients suffered from a neuroleptic-induced movement disorder. Globally, extrapyramidal adverse effects still impose a huge burden on the majority of neuroleptic-treated individuals with schizophrenia. The discrepancy between the standard identification methods for neuroleptic-induced movement disorder indicate the need for further research.

  6. Anticholinergics in the era of atypical antipsychotics: short-term or long-term treatment?

    PubMed

    Desmarais, Julie Eve; Beauclair, Linda; Margolese, Howard C

    2012-09-01

    Anticholinergic agents are usually prescribed to prevent or treat antipsychotic-induced extrapyramidal symptoms. Their long-term benefits are questionable and they carry diverse adverse effects, including cognitive impairment and worsening of tardive dyskinesia. This literature review explores the impact of anticholinergic medication discontinuation on movement disorders, cognition and psychopathology in patients receiving antipsychotics. Medline, Embase and PsycInfo were searched from 1950 to July 2011 using "cessation /withdrawal /discontinuation /stopping" with "anticholinergic*" or "antiparkinson*" and "neuroleptic*" or "antipsychotic*". Additional articles were obtained by searching the bibliographies of relevant references. Earlier studies of anticholinergic agent discontinuation in patients receiving first-generation antipsychotics reported relapse rates of extrapyramidal symptoms between 4% and 80%, reflecting the heterogeneity of the studies. Two recent studies of patients prescribed second-generation antipsychotics obtained relapse rates of 4% and 33%. Some studies suggest improvement in tardive dyskinesia with cessation of anticholinergics. Four studies examined the effects of anticholinergic agent discontinuation on cognition and all observed an improvement post-discontinuation. Changes in symptoms of schizophrenia with anticholinergic discontinuation are conflicting, with more recent studies suggesting an improvement. Given their questionable benefit with continued use, clinicians should consider a gradual withdrawal of anticholinergic agents in stable patients receiving antipsychotics.

  7. Movement Disorders Induced by the "Atypical" Antipsychotic Aripiprazole.

    PubMed

    Selfani, Karim; Soland, Valérie L; Chouinard, Sylvain; Huot, Philippe

    2017-01-01

    Aripiprazole is an antipsychotic that acts as a partial agonist at dopamine D2 receptors. Because of its partial agonist activity, it was believed that aripiprazole would be less susceptible than typical antipsychotics to induce extrapyramidal side effects. However, a few case-reports and case-series detailing aripiprazole-induced movement disorders have been published, suggesting that aripiprazole-induced movement disorders may arise. Here, we seek to report further cases of aripiprazole-induced movement disorders to raise the awareness of clinicians on this adverse effect. Patients referred to the André-Barbeau Movement Disorder clinic treated with aripiprazole were enrolled in this study. Their charts were retrospectively reviewed and data regarding past psychiatric history, past antipsychotic medication, duration of aripiprazole treatment, daily dose of aripiprazole administered, and resulting movement disorders were collected. We report 14 cases of parkinsonism, tardive dyskinesia and akathisia induced by aripiprazole. Some of these, mostly the parkinsonian phenotype, abated spontaneously following drug discontinuation, whereas others, mostly related to tardive phenomena, persisted after aripiprazole was discontinued, and required treatment. This case-series adds to the existing literature that suggests that movement disorders may arise following treatment with aripiprazole. Clinicians should be aware of this potential side effect when prescribing aripiprazole to patients.

  8. Experimental treatment of antipsychotic-induced movement disorders

    PubMed Central

    Shireen, Erum

    2016-01-01

    Antipsychotic drugs are extensively prescribed for the treatment of schizophrenia and other related psychiatric disorders. These drugs produced their action by blocking dopamine (DA) receptors, and these receptors are widely present throughout the brain. Therefore, extended antipsychotic use also leads to severe extrapyramidal side effects. The short-term effects include parkinsonism and the later appearing tardive dyskinesia. Currently available treatments for these disorders are mostly symptomatic and insufficient, and are often linked with a number of detrimental side effects. Antipsychotic-drug-induced tardive dyskinesia prompted researchers to explore novel drugs with fewer undesirable extrapyramidal side effects. Preclinical studies suggest a role of 5-hydroxytryptamine (serotonin)-1A and 2A/2C receptors in the modulation of dopaminergic neurotransmission and motivating a search for better therapeutic strategies for schizophrenia and related disorders. In addition, adjunctive treatment with antioxidants such as vitamin E, red rice bran oil, and curcumin in the early phases of illness may prevent additional oxidative injury, and thus improve and prevent further possible worsening of related neurological and behavioral deficits in schizophrenia. This review explains the role of serotonergic receptors and oxidative stress, with the aim of providing principles for prospect development of compounds to improve therapeutic effects of antischizophrenic drugs. PMID:27540314

  9. René Leriche and “Philosophy of Surgery” in the light of contemporary medical ethics

    PubMed Central

    Akça, Tamer; Aydın, Süha

    2013-01-01

    Prof. Dr. René Leriche was a famous French surgeon who lived between 1879 and 1955. After working as a vascular surgeon in Lyon, he was appointed professor at the University of Strasbourg in 1924 and later the Paris Collége de France in 1937. Leriche had proposed vascular patches as the ideal treatment for obliterated vascular segments and advocated the necessity of sympathectomy in arterial diseases in the 1920s. He defined “Leriche Syndrome” in 1923 which is known by his name and which develops as a result of incomplete obstruction of the aortic bifurcation. René Leriche wrote a monograph entitled “La Chirurgie de la Douleur-Pain Surgery” in 1940 and he also became a pioneer in the sympathectomy procedure for pain treatment. René Leriche focused on topics that must be remembered again today, including surgery advanced into science, the physiological basis of surgery, research methods, as well as issues such as business technology, humanity in surgery, surgical essence and surgeon’s qualifications in the book entitled “La Philosophie de la Chirurgie-Philosophy of Surgery” that he wrote in 1951. In this review, the issues that Prof. Dr. René Leriche addressed in middle of the 20th century were revised in the light of contemporary medical ethics. PMID:25931863

  10. Approche à l’égard des nouveaux anticoagulants oraux en pratique familiale

    PubMed Central

    Douketis, James; Bell, Alan David; Eikelboom, John; Liew, Aaron

    2014-01-01

    Résumé Objectif Traiter des différentes éventualités pouvant survenir durant le suivi clinique et la prise en charge prolongés des patients prenant de nouveaux anticoagulants oraux (NACO). Qualité des données Aux fins de cette révision narrative (non systématique), nous avons effectué une recherche dans la base de données PubMed afin de relever des études cliniques récentes (soit de janvier 2008 à la semaine 32 de 2013) portant sur l’emploi des NACO pour la prévention des AVC dans les cas de fibrillation auriculaire et le traitement de la thromboembolie veineuse aiguë. Nous avons utilisé cette base de données probantes pour répondre à nos questions prédéfinies ayant trait à l’emploi des NACO en pratique générale. Message principal Le dabigatran et le rivaroxaban doivent être pris avec les repas afin de limiter la dyspepsie et de favoriser l’absorption, respectivement. Aucun NACO n’est accompagné de restrictions alimentaires, à l’exception de la consommation modérée d’alcool, et le rivaroxaban et l’apixaban peuvent être écrasés, au besoin. Les antiacides ne semblent pas perturber l’efficacité des NACO. Comme c’est le cas avec la warfarine, les patients traités aux NACO doivent éviter l’emploi prolongé d’anti-inflammatoires non stéroïdiens et d’antiplaquettaires. Chez les patients devant subir une chirurgie, il faut interrompre la prise de NACO de 2 à 5 jours avant l’intervention, en fonction du risque de saignement, et le traitement par le NACO doit être habituellement repris au moins 24 heures après la chirurgie. Il n’est habituellement pas nécessaire d’effectuer un test préopératoire de coagulation. Chez les patients qui développent un saignement, un saignement mineur ne justifie habituellement pas un test de laboratoire ni l’interruption du traitement par le NACO; dans le cas des saignements majeurs, il faut se concentrer sur l’application de mesures localisées visant à endiguer le

  11. Valbenazine for tardive dyskinesia: A systematic review of the efficacy and safety profile for this newly approved novel medication-What is the number needed to treat, number needed to harm and likelihood to be helped or harmed?

    PubMed

    Citrome, Leslie

    2017-07-01

    The objective of this systematic review was to describe the efficacy, tolerability, and safety of valbenazine for the treatment of tardive dyskinesia (TD). The pivotal registration trials were accessed by querying http://www.ncbi.nlm.nih.gov/pubmed/ and http://www.clinicaltrials.gov, for the search terms 'valbenazine' OR 'NBI-98854', and by also querying the EMBASE (Elsevier) commercial database for clinical poster abstracts, and by asking the manufacturer for copies of posters presented at congresses. Product labeling provided additional information. All available clinical reports of studies were identified. Descriptions of the principal results and calculation of number needed to treat (NNT) and number needed to harm (NNH) for relevant dichotomous outcomes were extracted from the available study reports and other sources of information. Valbenazine, a reversible inhibitor of Vesicular Monoamine Transporter Type 2 (VMAT2), received approval for the treatment of TD in adults based on a clinical trial development programme that included three 6-week parallel group, randomised, placebo-controlled studies, including one Phase III trial described in product labeling. The recommended dose for valbenazine is 80 mg/d. The percentage of responders in the Phase III acute study, as defined by ≥50% reduction from baseline in the Abnormal Involuntary Movement Scale dyskinesia score was 40.0% for valbenazine 80 mg/d vs 8.7% for placebo, yielding a NNT of 4 (95% CI 3-6). As pooled from available data, discontinuation rates because of an adverse event were 2.9% for valbenazine-treated patients vs 1.6% for placebo-treated patients, resulting in a NNH of 76 (ns). The only adverse event that met the threshold of incidence ≥5% for valbenazine and a rate of ≥2 times than that observed with placebo was somnolence (somnolence, fatigue, sedation), with rates of 10.9% for valbenazine (all doses) vs 4.2% for placebo, resulting in a NNH of 15 (95% CI 9-52). An additional warning and

  12. 114.1 What is New in the Treatment of Schizophrenia?

    PubMed Central

    Correll, Christoph

    2017-01-01

    Abstract Background: Despite psychopharmacological advances, the evidence-based pharmacologic treatment of schizophrenia is still restricted to antidopaminergic compounds that predominantly address positive symptoms and agitation as well as aggression. Rational augmentation strategies to enhance effects in treatment resistant cases and to address relevant negative and cognitive symptoms are needed. Methods: Systematic review and critical appraisal of (1) meta-analytic evidence of augmentation and combination treatments, as well as (2) agents that are in phase III development for different domains on schizophrenia. Results: Out of 3397 publications, 29 meta-analyses testing 42 combination strategies in 381 individual trials and 19 833 participants were included. For total symptom reduction, 32 strategies augmenting any antipsychotic and 5 strategies augmenting clozapine were examined. Fourteen combination treatments outperformed control (SMD/Hedges’ g= −1.27 to −0.23). No combination strategies with clozapine outperformed control. Methodological quality of the meta-analyses was generally high (mean score = 9.4/11). However, content quality of the meta-analyzed studies was low (mean score = 2.8/8). Poorer content quality was significantly related to higher effect sizes in total psychopathology. We also identified 253 recent phase III clinical trials in schizophrenia that included 16 investigational compounds. Encenicline and valbenazine are first-in-class candidates for treatment of cognitive deficits and tardive dyskinesia, respectively, but recent encenicline data were negative. Eleven add-on compounds were previously approved for other therapeutic indications; they are for the most part being studied at academic medical centers and smaller pharmaceutical companies for new therapeutic targets (negative symptoms and cognitive deficits) or for specific populations with comorbidities and adverse effects (e.g., tardive dyskinesia and weight gain

  13. A secreted protein is an endogenous chemorepellant in Dictyostelium discoideum

    PubMed Central

    Phillips, Jonathan E.; Gomer, Richard H.

    2012-01-01

    Chemorepellants may play multiple roles in physiological and pathological processes. However, few endogenous chemorepellants have been identified, and how they function is unclear. We found that the autocrine signal AprA, which is produced by growing Dictyostelium discoideum cells and inhibits their proliferation, also functions as a chemorepellant. Wild-type cells at the edge of a colony show directed movement outward from the colony, whereas cells lacking AprA do not. Cells show directed movement away from a source of recombinant AprA and dialyzed conditioned media from wild-type cells, but not dialyzed conditioned media from aprA− cells. The secreted protein CfaD, the G protein Gα8, and the kinase QkgA are necessary for the chemorepellant activity of AprA as well as its proliferation-inhibiting activity, whereas the putative transcription factor BzpN is dispensable for the chemorepellant activity of AprA but necessary for inhibition of proliferation. Phospholipase C and PI3 kinases 1 and 2, which are necessary for the activity of at least one other chemorepellant in Dictyostelium, are not necessary for recombinant AprA chemorepellant activity. Starved cells are not repelled by recombinant AprA, suggesting that aggregation-phase cells are not sensitive to the chemorepellant effect. Cell tracking indicates that AprA affects the directional bias of cell movement, but not cell velocity or the persistence of cell movement. Together, our data indicate that the endogenous signal AprA acts as an autocrine chemorepellant for Dictyostelium cells. PMID:22711818

  14. Les séquelles de brûlures cervicales: aspects épidémiologique, clinique et thérapeutique au Maroc

    PubMed Central

    Rafik, Amine; Chabak, Hakim; Diouri, Mounia; Bahechar, Naïma; Chlihi, Abdessamad

    2015-01-01

    Les séquelles de brûlures cervicales représentent une entité fréquente des séquelles de brûlure, elles affectent la fonction, l'esthétique et l’état psychologique des patients et peuvent être de traitement difficile. Il s'agit d'une étude rétrospective étalée sur 5 ans de Mars 2009 au Octobre2014, réalisée au centre national des brûlés et de chirurgie plastique au CHU Ibn Rochd Casablanca. Nous avons analysé les caractéristiques épidémiologiqueset cliniques ainsi que les indications et les résultats thérapeutiques chez 300 patients présentant des rétractions cervicales post-brûlure, suivis dans notre formation. Les jeunes femmes étaient le plus souvent touchées (56%). la brûlure thermique par flamme de butane dans le cadre d'accident domestique était l’étiologie la plus fréquente (91%).75% des patients ont été pris en charge dans un délai de 18 mois après avoir présenté une incapacité fonctionnelle. Les brides cervicales modérées et sévères sont les plus fréquentes et représentent respectivement 60% et 16% des cas. Le traitement chirurgical a fait appel aux greffes cutanées dans 67%des cas, aux plasties locales dans 24%des cas et aux lambeaux dans 24% des cas, les résultats sont jugés bons dans 75%des cas et moyens dans 18% des cas, tandis que les cas restants (7%) ont nécessité une reprise chirurgicale. Le traitement des brides cervicales doit être associé à un programme de rééducation adapté, afin d'assurer la pérennité des résultats fonctionnels et esthétiques. PMID:26301017

  15. Fiabilité test retest et validité de construit de la version française de L'Échelle fonctionnelle des membres inférieurs (ÉFMI), partie II

    PubMed Central

    René, Frédéric; Casimiro, Lynn; Tremblay, Manon; Chea, Phanny; Létourneau, Liliane; Silva, Megan; Stockwell, Victoria; Bergeron, Louis-Philippe

    2011-01-01

    RÉSUMÉ Introduction : Le Lower Extremity Functional Scale a été traduit en français en 2006. La version canadienne-française se nomme l'Échelle fonctionnelle des membres inférieurs (ÉFMI). La validité de construit et la fiabilité test-retest de l'ÉFMI n'ont pas encore été examinées. But : Examiner la fiabilité test-retest, la consistance interne et la validité de construit de l'ÉFMI. Méthodologie : Trente-quatre participants ayant subi une chirurgie ou une blessure à un membre inférieur ont rempli un questionnaire démographique et complété l'ÉFMI lors d'une évaluation initiale alors qu'ils étaient hospitalisés. Ils ont à nouveau complété l'ÉFMI dans un intervalle de 72 heures après la première évaluation. Le coefficient de corrélation intra-classe (CCI) et le coefficient kappa ont été utilisés afin d'examiner la fiabilité de type test-retest de l'ÉFMI. Le coefficient alpha Cronbach a été calculé pour évaluer la consistance interne. L'analyse factorielle a été utilisée pour examiner la validité de construit afin de déterminer le nombre de dimensions et leur signification respective. Résultats : Le CCI s'élève à une valeur de 0,92 [0,88–0,96] (IC: 95%). Le résultat du test α-Cronbach est de 0,95 (0,91–0,99) IC à 95%. L'analyse factorielle révèle que tous les éléments de l'ÉFMI se logent sur une dimension principale. Conclusion : Les résultats montrent que la version canadienne-française de l'ÉFMI est un outil unidimensionnel qui offre une fiabilité test-retest et une consistance interne excellentes. PMID:22379266

  16. Compression médullaire d'origine métastatique

    PubMed Central

    Bouhafa, Touria; Elmazghi, Abderrahman; Masbah, Ouafae; Hassouni, Khalid

    2014-01-01

    La compression médullaire d'origine métastatique est une complication neurologique fréquente du cancer. C'est une urgence diagnostique et thérapeutique qui nécessite une prise en charge rapide et efficace. L'imagerie par résonnance magnétique (IRM) constitue l'examen de choix pour l'exploration de l'ensemble de la moelle. La prise en charge thérapeutique doit être multidisciplinaire incluant la corticothérapie, la radiothérapie et la chirurgie. PMID:25829974

  17. Compte rendu de la table ronde du 35ème congrès de la sfetb à metz (10-12 juin 2015) concernant les brûlures péribuccales

    PubMed Central

    Perrot, P.

    2016-01-01

    Summary La table ronde de chirurgie portant sur les brûlures péribuccales était divisée en deux parties: «prise en charge en aigu des brûlures péribuccales» et «séquelles de brûlures péribuccales / session de cas cliniques adulte et enfant». Ceci en est le résumé, construit en revoyant les prises vidéo en direct de la session, à laquelle assistait l’auteur PMID:28149241

  18. Cannabidiol Prevents Motor and Cognitive Impairments Induced by Reserpine in Rats.

    PubMed

    Peres, Fernanda F; Levin, Raquel; Suiama, Mayra A; Diana, Mariana C; Gouvêa, Douglas A; Almeida, Valéria; Santos, Camila M; Lungato, Lisandro; Zuardi, Antônio W; Hallak, Jaime E C; Crippa, José A; Vânia, D'Almeida; Silva, Regina H; Abílio, Vanessa C

    2016-01-01

    Cannabidiol (CBD) is a non-psychotomimetic compound from Cannabis sativa that presents antipsychotic, anxiolytic, anti-inflammatory, and neuroprotective effects. In Parkinson's disease patients, CBD is able to attenuate the psychotic symptoms induced by L-DOPA and to improve quality of life. Repeated administration of reserpine in rodents induces motor impairments that are accompanied by cognitive deficits, and has been applied to model both tardive dyskinesia and Parkinson's disease. The present study investigated whether CBD administration would attenuate reserpine-induced motor and cognitive impairments in rats. Male Wistar rats received four injections of CBD (0.5 or 5 mg/kg) or vehicle (days 2-5). On days 3 and 5, animals received also one injection of 1 mg/kg reserpine or vehicle. Locomotor activity, vacuous chewing movements, and catalepsy were assessed from day 1 to day 7. On days 8 and 9, we evaluated animals' performance on the plus-maze discriminative avoidance task, for learning/memory assessment. CBD (0.5 and 5 mg/kg) attenuated the increase in catalepsy behavior and in oral movements - but not the decrease in locomotion - induced by reserpine. CBD (0.5 mg/kg) also ameliorated the reserpine-induced memory deficit in the discriminative avoidance task. Our data show that CBD is able to attenuate motor and cognitive impairments induced by reserpine, suggesting the use of this compound in the pharmacotherapy of Parkinson's disease and tardive dyskinesia.

  19. The expression and genetics of resistance to stripe (yellow) rust in three European and four New Zealand wheat cultivars.

    PubMed

    Pathan, Amin K; Park, Robert F; Wellings, Colin R; Bariana, Harbans S

    2007-01-01

    Adult plant resistance (APR) to stripe rust in three European (Pegaso, Victo and Aztec) and four New Zealand cultivars (Weka, Kopara, Kokart and Takahe) was characterised using hybrid analysis and tests of allelism. In agreement with earlier work, the APR in most of these cultivars appeared to be controlled by two or more genes with additive effects. It was suggested that heavy selection pressure should be avoided in early generations in breeding programs utilising APR, because lines in which APR genes are heterozygous may display lower levels of resistance due to the incompletely dominant and interactive nature of many APRs. Such lines are capable of generating more resistant progenies following selfing. It was also demonstrated that it is possible to misclassify F2 plants as susceptible if APR genes are in a heterozygous condition, especially in the case of gene(s) conferring intermediate levels of resistance. The presence of a common APR gene in Kopara and Takahe, and perhaps Weka, was suggested because all shared a common parent in their pedigree and no susceptible plants were observed in F2 populations derived from intercrossing them. The difficulties inherent in conducting genetic studies on APRs and the need for large population sizes for such studies were emphasised.

  20. Résultats de la plastie tubaire: étude tunisienne

    PubMed Central

    Dimassi, Kaouther; Gharsa, Anissa; Chanoufi, Mohamed Badis; Sfar, Ezzeddine; Chelli, Dalenda

    2014-01-01

    L'infertilité d'origine tubo-péritonéale est toujours d'actualité, sa fréquence reste stable, sinon croissante. La coelioscopie permet à la fois d'affirmer l'atteinte tubaire et de proposer un geste thérapeutique adapté. Le but de notre travail est d’évaluer les résultats de la chirurgie laparoscopique des pathologies tubaires en termes de grossesses obtenues. Il s'agit d'une étude rétrospective descriptive, analytique et longitudinale. Nous avons colligé les patientes suivies pour infertilité et opérées pour pathologies tubaires distales au service A du centre de maternité et de néonatologie de Tunis. Nous avons étudié les caractéristiques épidémiologiques et cliniques des patientes, les résultats de l'imagerie et détaillé les gestes chirurgicaux réalisés. Les résultats de la chirurgie tubaire distale étaient exprimés en termes de grossesses obtenues avec un recul minimal de 12 mois et maximal de 5 ans. 898 patientes étaient prises en charge dans le service pour une infertilité dont 52 patientes avaient répondu aux critères d'inclusion à l’étude. La sensibilité de l'hystérosalpingographie en matière de lésions tubaire était de 69% et la spécificité de 100%. Selon le score d'opérabilité tubaire distale, 23% des lésions étaient classées au stade 4 et 13.46% au stade 1. Le taux de grossesses spontanées était de 8.69%, soit 13% des fimbrioplasties et 4% des néosalpingostomie. Le délai de conception allait de 4 à 9 mois. Les antécédents ou stigmates d'infection pelvienne étaient retenus comme facteur de mauvais pronostic. Une sélection rigoureuse des patientes à partir des données de l'hystérographie et de la coelioscopie est indispensable afin de déterminer les patientes candidates à une chirurgie réparatrice ou à une fécondation in vitro PMID:26113892

  1. [History of the German Society of Oromaxillofacial Surgery].

    PubMed

    Schwenzer, N

    2000-05-01

    The German Society of Oral and Maxillofacial Surgery was founded by Martin Wassmund in 1951. One of the main reasons was the need for scientific representation in the council at a medical convention. The Society, originally composed of 52 members, was first called "The German Society of Maxillofacial Surgery". In 1972, it extended its title to include the term "oral" ("Mund") and currently comprises 620 members. A scientific conference is held annually on a specific topic. The lectures given there have been published since 1954 in "Fortschritte der Kiefer- und Gesichts-Chirurgie" (Progress in Maxillofacial Surgery) by Thieme Verlag; since 1997, they have appeared as a Springer-Verlag supplement. Topics of choice are published in "Mund-, Kiefer- und Gesichtschirurgie" ("Oral and Maxillofacial Surgery"), originally by Hanser in Munich and now by Springer-Verlag in Heidelberg. In this manner, it was possible to completely document the scientific activities and progress in this specialty. Each year since 1957, a prize named after M. Wassmund, has been given for outstanding scientific accomplishment. The presidents, convention locations, topics, and prizewinners are listed in a table. Since the founding of the Society of Oral and Maxillofacial Surgery, close cooperation has existed with the National Association of German Oral and Maxillary-Facial Surgeons (Bundesverband der Deutschen Arzte für Mund-Kiefer-Gesichts-Chirurgie). In order to intertwine scientific and political interests, a fusion of these two organizations is planned for the year 2000.

  2. Cause rare d'une perforation de la cloison nasale

    PubMed Central

    Jahidi, Ali; Hemmaoui, Bouchaïb; Itoua, Wulfran Rosaire; Errami, Noureddine; Benariba, Fouad

    2014-01-01

    Les perforations de la cloison nasale constituent une pathologie fréquente en ORL. Leurs causes sont multiples et restent dominées par les traumatismes chirurgicaux. Les étiologies infectieuses et notamment la tuberculose sont rares. Nous présentons le cas d'une patiente ayant bénéficié d'une méatotomie bilatérale et chez laquelle une perforation de la cloison nasale a été découverte lors d'un examen systématique à un an de son intervention. D'abord considérée comme une complication de la chirurgie, la biopsie des berges de la perforation a permis de déterminer son origine tuberculeuse. La présentation clinique des perforations de la cloison nasale n'est pas spécifique. Elles sont souvent asymptomatiques et de découverte fortuite. Les traumatismes notamment chirurgicaux sont le plus siuvent en cause. L′orogine tuberculeuse resta très rare. Le diagnostic de certitude de tuberculose repose sur la biopsie des berges de cette perforation. Le but de ce travail est de mettre en avant l'intérêt de la biopsie dans le diagnostic de la tuberculose de la cloison nasale. Cette biopsie doit être systématique même en cas d'antécédents de chirurgie endonasale qui est le plus souvent en cause dans les perforations de la cloison nasale. PMID:24932334

  3. 48 CFR 1552.235-73 - Access to Federal Insecticide, Fungicide, and Rodenticide Act Confidential Business Information...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Insecticide, Fungicide, and Rodenticide Act Confidential Business Information (APR 1996). 1552.235-73 Section... Insecticide, Fungicide, and Rodenticide Act Confidential Business Information (APR 1996). As prescribed in... Act Confidential Business Information (APR 1996) In order to perform duties under the contract, the...

  4. Nascer no Brasil: the presence of a companion favors the use of best practices in delivery care in the South region of Brazil.

    PubMed

    Monguilhott, Juliana Jacques da Costa; Brüggemann, Odaléa Maria; Freitas, Paulo Fontoura; d'Orsi, Eleonora

    2018-01-01

    OBJECTIVE To analyze if the presence of a companion favors the use of best practices in the delivery care in the South region of Brazil. METHODS This is a cross-sectional analysis of the longitudinal study Nascer no Brasil. We analyzed data from 2,070 women from the South region of Brazil who went into labor. The data were collected between February and August 2011, by interviews and medical records. We performed a bivariate and multivariate analysis, calculating the crude and adjusted prevalence ratios using Poisson regression with robust variance estimation. The level of significance adopted was 5%. RESULTS Most women had a companion during labor (51.7%), but few remained during delivery (39.4%) or cesarean section (34.8%). Less than half of the women had access to several recommended practices, while non-recommended practices continue to be performed. In the model adjusted for age, education level, source of payment for the delivery, parity, and score of the Brazilian Association of Market Research Institutes, the presence of a companion was statistically associated with a greater supply of liquids and food (aPR = 1.34), dietary prescription (aPR = 1.34), use of non-pharmacological methods for pain relief (aPR = 1.37), amniotomy (aPR = 1.10), epidural or spinal analgesia (aPR = 1.84), adoption of non-lithotomy position in the delivery (aPR = 1.77), stay in the same room during labor, delivery, and postpartum (aPR = 1.62), skin-to-skin contact in the delivery (aPR = 1.81) and cesarean section (PR = 2.43), as well as reduced use of the Kristeller maneuver (aPR = 0.67), trichotomy (aPR = 0.59), and enema (aPR = 0.49). CONCLUSIONS In the South region of Brazil, most women do not have access to the best practices in addition to undergoing several unnecessary interventions. The presence of a companion is associated with several beneficial practices and the reduction in some interventions, although other interventions are not impacted.

  5. Nascer no Brasil: the presence of a companion favors the use of best practices in delivery care in the South region of Brazil

    PubMed Central

    Monguilhott, Juliana Jacques da Costa; Brüggemann, Odaléa Maria; Freitas, Paulo Fontoura; d'Orsi, Eleonora

    2018-01-01

    ABSTRACT OBJECTIVE To analyze if the presence of a companion favors the use of best practices in the delivery care in the South region of Brazil. METHODS This is a cross-sectional analysis of the longitudinal study Nascer no Brasil. We analyzed data from 2,070 women from the South region of Brazil who went into labor. The data were collected between February and August 2011, by interviews and medical records. We performed a bivariate and multivariate analysis, calculating the crude and adjusted prevalence ratios using Poisson regression with robust variance estimation. The level of significance adopted was 5%. RESULTS Most women had a companion during labor (51.7%), but few remained during delivery (39.4%) or cesarean section (34.8%). Less than half of the women had access to several recommended practices, while non-recommended practices continue to be performed. In the model adjusted for age, education level, source of payment for the delivery, parity, and score of the Brazilian Association of Market Research Institutes, the presence of a companion was statistically associated with a greater supply of liquids and food (aPR = 1.34), dietary prescription (aPR = 1.34), use of non-pharmacological methods for pain relief (aPR = 1.37), amniotomy (aPR = 1.10), epidural or spinal analgesia (aPR = 1.84), adoption of non-lithotomy position in the delivery (aPR = 1.77), stay in the same room during labor, delivery, and postpartum (aPR = 1.62), skin-to-skin contact in the delivery (aPR = 1.81) and cesarean section (PR = 2.43), as well as reduced use of the Kristeller maneuver (aPR = 0.67), trichotomy (aPR = 0.59), and enema (aPR = 0.49). CONCLUSIONS In the South region of Brazil, most women do not have access to the best practices in addition to undergoing several unnecessary interventions. The presence of a companion is associated with several beneficial practices and the reduction in some interventions, although other interventions are not impacted. PMID:29364356

  6. Usefulness of threshold dose to prevent damage of underlying tissue by PDT treatment: an in-vitro study on chondrocytes

    NASA Astrophysics Data System (ADS)

    Placzek, R.; Kempka, G.; Ruether, W.; Moser, Joerg G.

    1995-03-01

    Arthritic synovitis is best cured by total removal of the inflamed synovia (equals synovectomy). This can be performed by open chirurgy, by arthroscopy, or by radiosynoviothesis, i.e., injection of (beta) -radiating rare earth metals into the joint cavity. All these procedures are more or less non-quantitative and may lead to a recidive. The idea was to destroy the inflamed synovia by PDT without destruction of the underlying tissue (cartilage and bone). So, the sensitivity of the cartilage-building cells, which can be grown in cell culture, has to be studied.

  7. Traumatisme de la main par injection a haute pression

    PubMed Central

    Mabchoure, K.; Diouri, M.; Bahechar, N.; Chlihi, A.

    2016-01-01

    Summary Les traumatismes de la main par injection à haute pression sont des accidents relativement rares et souvent mal connus par le praticien. Les lésions qui dépendent du produit injecté et du site d’injection sont pourvoyeuses de séquelles esthétiques et fonctionnelles lourdes. Le traitement repose sur la chirurgie, l’antibiothérapie et la rééducation précoce et spécifique. Nous rapportons notre expérience ainsi qu’une revue de la littérature. PMID:27857654

  8. Anal canal squamous cell cancer: are surgical alternatives to chemoradiation just as effective?

    PubMed

    Suradkar, Kunal; Pappou, Emmanouil E; Lee-Kong, Steven A; Feingold, Daniel L; Kiran, Ravi P

    2018-02-01

    The purpose of this paper is to study long-term oncologic outcomes after different treatment strategies for anal canal cancer (SCAC). Patients with SCAC (2004-2013) were identified from Surveillance, Epidemiology, and End Results (SEER) database. Patients undergoing radiation (RT) were compared to those undergoing local excision (LE), abdominoperineal resection (APR), and abdominoperineal resection after radiation (RT + APR). Overall survival (OS) and cancer-specific survival (CSS) data were evaluated using Kaplan-Meier and Cox regression. Two thousand seven hundred and seventy-two (83.8%) patients underwent RT, 382 (11.6%) LE, 77 (2.3%) APR, 76 (2.3%) RT + APR. Median age for the four groups was 60, 57, 64, and 56 years and 32, 49.7, 53.2, and 39.5% were male, respectively, while median tumor size was 4.4, 2.6, 5.3, and 5.5 cm, respectively. Five-year OS of RT, LE, APR, and RT + APR groups was 63.7, 79.6, 25.8, and 41.8% while CSS was 79.6, 92.5, 75.6, and 58.8%, respectively, (p < 0.001). Adjusted hazard ratios for OS for LE, APR, and RT + APR with RT as reference were 1.007 (0.702-1.444), 2.311 (1.367-3.906), and 2.072 (1.016-4.228), respectively. These data suggest that APR does not provide better outcomes in treatment of SCAC. Chemoradiation remains the gold standard treatment for majority of patients. Local excision is associated with favorable outcomes in some circumstances.

  9. How does self-injury feel? Examining automatic positive reinforcement in adolescent self-injurers with experience sampling.

    PubMed

    Selby, Edward A; Nock, Matthew K; Kranzler, Amy

    2014-02-28

    One of the most frequently reported, yet understudied, motivations for non-suicidal self-injury (NSSI) involves automatic positive reinforcement (APR), wherein sensations arising from NSSI reinforce and promote the behavior. The current study used experience sampling methodology with a clinical sample of self-injuring adolescents (N=30) over a 2-week period during which the adolescents reported NSSI behaviors, and rated if an APR motivation was present, and if so whether that motivation pertained to feeling "pain," "stimulation," or "satisfaction." Over 50% of the sample reported at least one instance of NSSI for APR reasons. No significant differences were found on demographic factors or psychiatric comorbidity for those with and without an APR motivation. However, those with an APR motivation reported elevated NSSI thoughts, longer duration of those thoughts, and more NSSI behaviors. They also reported more alcohol use thoughts, alcohol use, impulsive spending, and binge eating. The most commonly reported sensation following NSSI for APR was "satisfaction." However those endorsing feeling pain reported the most NSSI behaviors. These findings provide new information about the APR motivations for NSSI and shed light on the different sensations felt. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Latin America Report

    DTIC Science & Technology

    1985-05-14

    AMERICAN AFFAIRS Andean Group Tries To Adjust Policy To Economic Reality (EL SIGLO , 8 Apr 85) 1 ARGENTINA ILA NACION Assesses Alfonsin’s Visit to...Port Labor, Pension Reforms (EL SIGLO , 8 Apr 85) 135 Government Begins Second Phase of Social Plan for Peace (EL TIEMPO, 8 Apr 85) 139 Briefs... SIGLO in Spanish 8 Apr 85 pp 1, 2 [Text] This week Colombia, Bolivia, Ecuador, Peru and Venezuela will try to finalize the new bases for a regional

  11. 76 FR 11944 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ...) RWY 16, Amdt 1 Intl. 7-Apr-11 TX Houston Willam P Hobby...... 1/4558 2/7/11 ILS OR LOC RWY 12R, Amdt 12 7-Apr-11 TX Houston Willam P Hobby...... 1/4559 2/7/11 RNAV (GPS) RWY 22, Amdt 2 7-Apr-11 TN...

  12. 77 FR 19154 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ..., Washington, DC 20410, telephone number 202-401- 7914 (this is not a toll-free number). Hearing- or speech... formula information that must be included in the IHP and Annual Performance Report (APR), as well as the... monitoring, APRs, APR review, HUD performance measures, recipient comments on HUD reports, remedial actions...

  13. Relationship between potential aggregation-prone regions and HLA-DR-binding T-cell immune epitopes: implications for rational design of novel and follow-on therapeutic antibodies.

    PubMed

    Kumar, Sandeep; Mitchell, Mark A; Rup, Bonita; Singh, Satish K

    2012-08-01

    Aggregation and unwanted immunogenicity are hurdles to avoid in successful commercial development of antibody-based therapeutics. In this article, the relationship between aggregation-prone regions (APRs), capable of forming cross-β motifs/amyloid fibrils, and major histocompatibility complex class II-restricted human leukocyte antigen (HLA)-DR-binding T-cell immune epitopes (TcIEs) is analyzed using amino acid sequences of 25 therapeutic antibodies, 55 TcIEs recognized by T-regulatory cells (tregitopes), 1000 randomly generated 15-residue-long peptides, 2257 human self-TcIEs (autoantigens), and 11 peptides in HLA-peptide cocrystal structures. Sequence analyses from these diverse sources consistently show a high level of correlation between APRs and TcIEs: approximately one-third of TcIEs contain APRs, but the majority of APRs occur within TcIE regions (TcIERs). Tregitopes also contain APRs. Most APR-containing TcIERs can bind multiple HLA-DR alleles, suggesting that aggregation-driven adverse immune responses could impact a broad segment of patient population. This article has identified common molecular sequence-structure loci that potentially contribute toward both manufacturability and safety profiles of the therapeutic antibodies, thereby laying a foundation for simultaneous optimization of these attributes in novel and follow-on candidates. Incidence of APRs within TcIERs is not special to biotherapeutics, self-TcIEs from human proteins, involved in various diseases, also contain predicted APRs and experimentally proven amyloid-fibril-forming peptide sequence portions. Copyright © 2012 Wiley Periodicals, Inc.

  14. Respiratory protection during simulated emergency pediatric life support: a randomized, controlled, crossover study.

    PubMed

    Schumacher, Jan; Gray, Stuart A; Michel, Sophie; Alcock, Roger; Brinker, Andrea

    2013-02-01

    Emergency pediatric life support (EPLS) of children infected with transmissible respiratory diseases requires adequate respiratory protection for medical first responders. Conventional air-purifying respirators (APR) and modern loose-fitting powered air-purifying respirator-hoods (PAPR-hood) may have a different impact during pediatric resuscitation and therefore require evaluation. This study investigated the influence of APRs and PAPR-hoods during simulated pediatric cardiopulmonary resuscitation. Study design was a randomized, controlled, crossover study. Sixteen paramedics carried out a standardized EPLS scenario inside an ambulance, either unprotected (control) or wearing a conventional APR or a PAPR-hood. Treatment times and wearer comfort were determined and compared. All paramedics completed the treatment objectives of the study arms without adverse events. Study subjects reported that communication, dexterity and mobility were significantly better in the APR group, whereas the heat-build-up was significantly less in the PAPR-hood group. Treatment times compared to the control group did not significantly differ for the APR group but did with the PAPR-hood group (261±12 seconds for the controls, 275±9 seconds for the conventional APR and 286±13 seconds for the PAPR-hood group, P < .05. APRs showed a trend to better treatment times compared to PAPR-hoods during simulated pediatric cardiopulmonary resuscitation. Study participants rated mobility, ease of communication and dexterity with the tight-fitting APR system significantly better compared to the loose-fitting PAPR-hood.

  15. Coadministration of Hedera helix L. Extract Enabled Mice to Overcome Insufficient Protection against Influenza A/PR/8 Virus Infection under Suboptimal Treatment with Oseltamivir

    PubMed Central

    Shim, Aeri; Lee, Bo-Ra; Kwon, Bo-Eun; Song, Hyuk-Hwan; Kim, Yeon-Jeong; Chang, Sun-Young; Jeong, Hyeon Gun; Kim, Jong Geal; Seo, Sang-Uk; Kim, HyunPyo; Kwon, YongSoo; Ko, Hyun-Jeong

    2015-01-01

    Several anti-influenza drugs that reduce disease manifestation exist, and although these drugs provide clinical benefits in infected patients, their efficacy is limited by the emergence of drug-resistant influenza viruses. In the current study, we assessed the therapeutic strategy of enhancing the antiviral efficacy of an existing neuraminidase inhibitor, oseltamivir, by coadministering with the leaf extract from Hedera helix L, commonly known as ivy. Ivy extract has anti-inflammatory, antibacterial, antifungal, and antihelminthic properties. In the present study, we investigated its potential antiviral properties against influenza A/PR/8 (PR8) virus in a mouse model with suboptimal oseltamivir that mimics a poor clinical response to antiviral drug treatment. Suboptimal oseltamivir resulted in insufficient protection against PR8 infection. Oral administration of ivy extract with suboptimal oseltamivir increased the antiviral activity of oseltamivir. Ivy extract and its compounds, particularly hedrasaponin F, significantly reduced the cytopathic effect in PR8-infected A549 cells in the presence of oseltamivir. Compared with oseltamivir treatment alone, coadministration of the fraction of ivy extract that contained the highest proportion of hedrasaponin F with oseltamivir decreased pulmonary inflammation in PR8-infected mice. Inflammatory cytokines and chemokines, including tumor necrosis factor-alpha and chemokine (C-C motif) ligand 2, were reduced by treatment with oseltamivir and the fraction of ivy extract. Analysis of inflammatory cell infiltration in the bronchial alveolar of PR8-infected mice revealed that CD11b+Ly6G+ and CD11b+Ly6Cint cells were recruited after virus infection; coadministration of the ivy extract fraction with oseltamivir reduced infiltration of these inflammatory cells. In a model of suboptimal oseltamivir treatment, coadministration of ivy extract fraction that includes hedrasaponin F increased protection against PR8 infection that could be

  16. Coadministration of Hedera helix L. Extract Enabled Mice to Overcome Insufficient Protection against Influenza A/PR/8 Virus Infection under Suboptimal Treatment with Oseltamivir.

    PubMed

    Hong, Eun-Hye; Song, Jae-Hyoung; Shim, Aeri; Lee, Bo-Ra; Kwon, Bo-Eun; Song, Hyuk-Hwan; Kim, Yeon-Jeong; Chang, Sun-Young; Jeong, Hyeon Gun; Kim, Jong Geal; Seo, Sang-Uk; Kim, HyunPyo; Kwon, YongSoo; Ko, Hyun-Jeong

    2015-01-01

    Several anti-influenza drugs that reduce disease manifestation exist, and although these drugs provide clinical benefits in infected patients, their efficacy is limited by the emergence of drug-resistant influenza viruses. In the current study, we assessed the therapeutic strategy of enhancing the antiviral efficacy of an existing neuraminidase inhibitor, oseltamivir, by coadministering with the leaf extract from Hedera helix L, commonly known as ivy. Ivy extract has anti-inflammatory, antibacterial, antifungal, and antihelminthic properties. In the present study, we investigated its potential antiviral properties against influenza A/PR/8 (PR8) virus in a mouse model with suboptimal oseltamivir that mimics a poor clinical response to antiviral drug treatment. Suboptimal oseltamivir resulted in insufficient protection against PR8 infection. Oral administration of ivy extract with suboptimal oseltamivir increased the antiviral activity of oseltamivir. Ivy extract and its compounds, particularly hedrasaponin F, significantly reduced the cytopathic effect in PR8-infected A549 cells in the presence of oseltamivir. Compared with oseltamivir treatment alone, coadministration of the fraction of ivy extract that contained the highest proportion of hedrasaponin F with oseltamivir decreased pulmonary inflammation in PR8-infected mice. Inflammatory cytokines and chemokines, including tumor necrosis factor-alpha and chemokine (C-C motif) ligand 2, were reduced by treatment with oseltamivir and the fraction of ivy extract. Analysis of inflammatory cell infiltration in the bronchial alveolar of PR8-infected mice revealed that CD11b+Ly6G+ and CD11b+Ly6Cint cells were recruited after virus infection; coadministration of the ivy extract fraction with oseltamivir reduced infiltration of these inflammatory cells. In a model of suboptimal oseltamivir treatment, coadministration of ivy extract fraction that includes hedrasaponin F increased protection against PR8 infection that could be

  17. Antiretroviral Prescription and Viral Suppression in a Representative Sample of HIV-Infected Persons in Care in 4 Large Metropolitan Areas of the United States, Medical Monitoring Project, 2011-2013.

    PubMed

    Wohl, Amy Rock; Benbow, Nanette; Tejero, Judith; Johnson, Christopher; Scheer, Susan; Brady, Kathleen; Gagner, Alexandra; Hughes, Alison; Eberhart, Michael; Mattson, Christine; Skarbinski, Jacek

    2017-10-01

    Comparisons of antiretroviral therapy (ART) prescription and viral suppression among people in HIV care across US metropolitan areas are limited. Medical Monitoring Project, 2011-2013, data were used to describe and compare associations between sociodemographics and ART prescription and viral suppression for persons receiving HIV care. Chicago, Los Angeles County (LAC), Philadelphia, and San Francisco in the United States. Bivariate and multivariable methods were used. The proportion of patients prescribed ART (91%-93%) and virally suppressed (79%-88%) was consistent although more persons were virally suppressed in San Francisco compared with the other areas, and a smaller proportion was virally suppressed in Philadelphia compared with Chicago. In the combined cohort, persons aged 30-49 years were less likely than persons 50+ (adjusted prevalence ratio (aPR) -0.97, confidence interval (CI): 0.94 to 0.99); persons reporting non-injection drug use were less likely than non-users (aPR = 0.94, CI: 0.90 to 0.98); and Hispanics were more likely than whites (aPR - 1.04, CI: 1.01 to 1.08) to be prescribed ART. Blacks (aPR = 0.93; CI: 0.87 to 0.99) and homeless persons (aPR = 0.87; CI: 0.80 to 0.95) were less likely to be virally suppressed in the combined cohort. In LAC, persons aged 30-49 years were less likely than those 50+ to be prescribed ART (aPR = 0.94, CI: 0.90 to 0.98). Younger persons (18-29) (aPR = 0.77; CI: 0.60 to 0.99) and persons with less than a high school education (aPR = 0.80; CI: 0.67 to 0.95) in Philadelphia, blacks (aPR = 0.90; CI: 0.83 to 0.99) and men who have sex with women only (aPR = 0.89; CI: 0.80 to 0.99) in Chicago, and homeless individuals in LAC (aPR = 0.80; CI: 0.67 to 0.94) were less likely to be virally suppressed. Data highlight the need to increase ART prescription to achieve viral suppression among younger persons, noninjection drug users, blacks, and homeless persons in US metropolitan areas and underscores the importance of region

  18. Surface-Based Observations of Contrail Occurrence Over the US, Apr. 1993 to Apr. 1994

    NASA Technical Reports Server (NTRS)

    Minnis, Patrick; Ayers, J. Kirk; Weaver, Steven P.

    1997-01-01

    Surface observers stationed at 19 U.S. Air Force Bases and Army Air Stations recorded the daytime occurrence of contrails and cloud fraction on an hourly basis for the period April 1993 through April 1994. Each observation uses one of four main categories to report contrails as unobserved, non-persistent, persistent, and indeterminate. Additional classification includes the co-occurrence of cirrus with each report. The data cover much of the continental U.S. including locations near major commercial air routes. The mean annual frequency of occurrence in unobstructed viewing conditions is 13 percent for these sites. Contrail occurrence varied substantially with location and season. Most contrails occurred during the winter months and least during the summer with a pronounced minimum during July. Although nocturnal observations are not available, it appears that the contrails have a diurnal variation that peaks during mid morning over most areas. Contrails were most often observed in areas near major commercial air corridors and least often over areas far removed from the heaviest air traffic. A significant correlation exists between mean contrail frequency and aircraft fuel usage above 7 km suggesting predictive potential for assessing future contrail effects on climate.

  19. Optimizing Hemodynamic Support of Acute Spinal Cord Injury Based on Injury Mechanism

    DTIC Science & Technology

    2016-10-01

    lnJury Specifics Force Weig Tre.tment Notes ht (k&) 8178 Andrew the Giant Yucatan 1-Apr-16 2585.52 25.0 CNTR PILOTTING: unst1ble MAP 8177 Brett...Hart Yucatan 6-Apr-16 3210.77 26.0 CNTR MAP inf11sion: 8202 Coco B. Ware Yucatan 24-Apr-16 2967.00 26.5 NEQJmp(30 min) 60-min Norepinephrine 20...mmHg above BSL 8192 Diamond D. Page Yucatan 27-Apr-16 3609.00 25.0 CNTR 8179 Edge Yucatan 3-May-16 Contusion: 3423.00 26.0 CNTR Groups: - CNTR: no

  20. Grand Lake Saint Marys, Ohio, Survey Report for Flood Control and Allied Purposes. Volume 1.

    DTIC Science & Technology

    1981-08-01

    nuprotected shoreline have reduced the lake depth. A range of structural and, nanatructural flood damage reduction1 usasures wee exmined. Nonstructural masaes ...24 330 Apr 1972 872.67 32 310 Apr 1938 872.42 19 550 Feb 1950 872.42 24 520 Apr 1978 872.17 37 380 Jan 1949 872.08 19 260 Apr 1957 872.08 23 550 Jun...1958 871.92 11 380 May 1933 871.92 5 490 Nov 1972 871.92 9 510 16 . ..... Ie Flood Damages The areas under consideration include Beaver Creek

  1. Cost-utility and budget impact analyses of the use of NEPA for chemotherapy-induced nausea and vomiting prophylaxis in Italy

    PubMed Central

    Restelli, Umberto; Saibene, Gabriella; Nardulli, Patrizia; Di Turi, Roberta; Bonizzoni, Erminio; Scolari, Francesca; Perrone, Tania; Croce, Davide; Celio, Luigi

    2017-01-01

    Objective To evaluate the efficiency of resources allocation and sustainability of the use of netupitant+palonosetron (NEPA) for chemotherapy-induced nausea and vomiting (CINV) prophylaxis assuming the Italian National Health Service (NHS) perspective. A published Markov model was adapted to assess the incremental cost-utility ratio of NEPA compared with aprepitant (APR) + palonosetron (PALO), fosaprepitant (fAPR) + PALO, APR + ondansetron (ONDA), fAPR + ONDA in patients receiving a highly emetogenic chemotherapy (HEC) and with APR + PALO and fAPR + PALO in patients receiving a moderately emetogenic chemotherapy (MEC). Setting Oncology hospital department in Italy. Methods A Markov model was used to determine the impact of NEPA on the budget of the Italian NHS on a 5-day time horizon, corresponding to the acute and delayed CINV prophylaxis phases. Direct medical costs considered were related to antiemetic drugs, adverse events management, CINV episodes management. Clinical and quality of life data referred to previously published works. The budget impact analysis considered the aforementioned therapies plus PALO alone (for HEC and MEC) on a 5-year time horizon, comparing two scenarios: one considering the use of NEPA and one not considering its use. Primary and secondary outcome measures Incremental cost per quality adjusted life year (QALY) and differential economic impact for the Italian NHS between the two scenarios considered. Results NEPA is more effective and less expensive (dominant) compared with APR + PALO (for HEC and MEC), fAPR + PALO (for HEC and MEC), APR + ONDA (for HEC), fAPR + ONDA (for HEC). The use of NEPA would lead to a 5-year cost decrease of €63.7 million (€42.7 million for HEC and €20.9 million for MEC). Conclusions NEPA allows an efficient allocation of resources for the Italian NHS and it is sustainable, leading to a cost decrease compared with a scenario which does not consider its use. PMID:28765126

  2. Cost-utility and budget impact analyses of the use of NEPA for chemotherapy-induced nausea and vomiting prophylaxis in Italy.

    PubMed

    Restelli, Umberto; Saibene, Gabriella; Nardulli, Patrizia; Di Turi, Roberta; Bonizzoni, Erminio; Scolari, Francesca; Perrone, Tania; Croce, Davide; Celio, Luigi

    2017-08-01

    To evaluate the efficiency of resources allocation and sustainability of the use of netupitant+palonosetron (NEPA) for chemotherapy-induced nausea and vomiting (CINV) prophylaxis assuming the Italian National Health Service (NHS) perspective. A published Markov model was adapted to assess the incremental cost-utility ratio of NEPA compared with aprepitant (APR) + palonosetron (PALO), fosaprepitant (fAPR) + PALO, APR + ondansetron (ONDA), fAPR + ONDA in patients receiving a highly emetogenic chemotherapy (HEC) and with APR + PALO and fAPR + PALO in patients receiving a moderately emetogenic chemotherapy (MEC). Oncology hospital department in Italy. A Markov model was used to determine the impact of NEPA on the budget of the Italian NHS on a 5-day time horizon, corresponding to the acute and delayed CINV prophylaxis phases. Direct medical costs considered were related to antiemetic drugs, adverse events management, CINV episodes management. Clinical and quality of life data referred to previously published works. The budget impact analysis considered the aforementioned therapies plus PALO alone (for HEC and MEC) on a 5-year time horizon, comparing two scenarios: one considering the use of NEPA and one not considering its use. Incremental cost per quality adjusted life year (QALY) and differential economic impact for the Italian NHS between the two scenarios considered. NEPA is more effective and less expensive (dominant) compared with APR + PALO (for HEC and MEC), fAPR + PALO (for HEC and MEC), APR + ONDA (for HEC), fAPR + ONDA (for HEC). The use of NEPA would lead to a 5-year cost decrease of €63.7 million (€42.7 million for HEC and €20.9 million for MEC). NEPA allows an efficient allocation of resources for the Italian NHS and it is sustainable, leading to a cost decrease compared with a scenario which does not consider its use. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  3. Protective effects of aqueous fruit extract from Sea Buckthorn (Hippophae rhamnoides L. Spp. Turkestanica) on haloperidol-induced orofacial dyskinesia and neuronal alterations in the striatum.

    PubMed

    Batool, Farhat; Shah, Asad Hussain; Ahmed, Syed Dilnawaz; Saify, Zafar Saeid; Haleem, Darakhshan Jabeen

    2010-08-01

    Long-term treatment of haloperidol, a neuroleptic, induces neurodegeneration specifically in the striatum (caudate and putamen), which plays an important role in the development of orofacial dyskinesia, a putative model of tardive dyskinesia (TD). This study investigated the protective effects of a concomitant treatment of aqueous fruit extract of Sea buckthorn (Hippophae rhamnoides L. spp. Turkestanica) (SBT-FE) (40 mg/kg, orally) plus haloperidol (3.0 mg/kg, ip) administration on an animal model of TD and on striatal neuronal alterations. Rats received daily haloperidol (3.0 mg/kg ip) and saline injections for 15 days. Seven-day posttreatment, aqueous SBT-FE (40 mg/kg) was administered daily via a feeding tube. Hypolocomotive effects (home cage activity, exploratory activity, catalepsy, and vacuous chewing movements) were monitored consecutively in each group. On the last day of the experiments, changes in extracellular levels of striatal dopamine (DA), dihydroxyphenyl acetic acid (DOPAC) and homovanillic acid (HVA) were determined by HPLC-EC. Aqueous SBT-FE attenuated haloperidol-induced VCMs after second week of treatment and locomotor activity was greater in rats treated with SBT-FE compared with the controls. The results indicate that DA and HVA levels in the striatum were significantly (P <.01) altered in rats given SBT-FE before injections of haloperidol. Hippophae rhamnoides fruit extract has a protective role against haloperidol-induced orofacial dyskinesia. Consequently, use of Hippophae rhamnoides as a possible therapeutic agent for the treatment of tardive dyskinesia should be considered.

  4. Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos.

    PubMed

    Sheehan, Diana M; Cosner, Chelsea; Fennie, Kristopher P; Gebrezgi, Merhawi T; Cyrus, Elena; Maddox, Lorene M; Levison, Julie H; Spencer, Emma C; Niyonsenga, Theophile; Trepka, Mary Jo

    2018-04-01

    The objective of this study was to estimate disparities in linkage to human immunodeficiency virus (HIV) care among Latinos by country/region of birth, HIV testing site, and neighborhood characteristics. A retrospective study was conducted using Florida HIV surveillance records of Latinos/Hispanics aged ≥13 diagnosed during 2014-2015. Linkage to HIV care was defined as a laboratory test (HIV viral load or CD4) within 3 months of HIV diagnosis. Multi-level Poisson regression models were used to estimate adjusted prevalence ratios (aPR) for nonlinkage to care. Of 2659 Latinos, 18.8% were not linked to care within 3 months. Compared with Latinos born in mainland United States, those born in Cuba [aPR 0.60, 95% confidence interval (CI) 0.47-0.76] and Puerto Rico (aPR 0.61, 95% CI 0.41-0.90) had a decreased prevalence of nonlinkage. Latinos diagnosed at blood banks (aPR 2.34, 95% CI 1.75-3.12), HIV case management and screening facilities (aPR 1.76, 95% CI 1.46-2.14), and hospitals (aPR 1.42, 95% CI 1.03-1.96) had an increased prevalence of nonlinkage compared with outpatient general, infectious disease, and tuberculosis/sexually transmitted diseases/family planning clinics. Latinos who resided in the lowest (aPR 1.57, 95% CI 1.19-2.07) and third lowest (aPR 1.33, 95% CI 1.01-1.76) quartiles of neighborhood socioeconomic status compared with the highest quartile were at increased prevalence. Latinos who resided in neighborhoods with <25% Latinos also had increased prevalence of nonlinkage (aPR 1.23, 95% CI 1.01-1.51). Testing site at diagnosis may be an important determinant of HIV care linkage among Latinos due to neighborhood or individual-level resources that determine location of HIV testing.

  5. Prevalence, awareness, treatment, control and socio demographic determinants of hypertension in Malaysian adults.

    PubMed

    Abdul-Razak, Suraya; Daher, Aqil Mohammad; Ramli, Anis Safura; Ariffin, Farnaza; Mazapuspavina, Md Yasin; Ambigga, Krishnapillai S; Miskan, Maizatullifah; Abdul-Hamid, Hasidah; Mat-Nasir, Nafiza; Nor-Ashikin, Mohamed Noor Khan; Ng, Kien Keat; Nawawi, Hapizah; Yusoff, Khalid

    2016-04-21

    Hypertension is the leading cardiovascular risk factor globally as well as in Malaysia. This study aimed to estimate the prevalence, awareness, treatment, control and the socio demographic determinants of hypertension among Malaysian adults. The analytic sample consisted of 11,288 adults aged ≥ 30 years recruited at baseline in 2007-2011 from the REDISCOVER Study which is an ongoing, prospective cohort study involving 18 urban and 22 rural communities in Malaysia. Socio-demographics, anti-hypertensive treatment details and an average of at least two blood pressure measurements were obtained. The age-adjusted prevalence was 42.0 % (CI: 40.9-43.2) and was higher in men [43.5 % (CI: 41.2-45.0)] than women [41.0 % (CI: 39.8-42.3)]. Participants from rural areas (APR: 1.12, CI: 1.04-1.20); aged at least 40-49 years (APR: 1.86, CI: 1.62-2.14); who were overweight (APR: 1.24, CI: 1.15-1.34) and obese (APR: 1.54, CI: 1.43-1.6) were more likely to have hypertension. The Indigenous ethnic group was less likely to be aware (APR: 0.81, CI: 0.69-0.92) and to be on treatment (APR: 0.66, CI: 0.55-0.79). Those in rural areas were less likely to have their hypertension controlled (APR: 0.61, CI: 0.49-0.75). On the other hand, control was more likely in females (APR: 1.25, CI: 1.01-1.54) and Indigenous group (APR: 1.64, CI: 1.19-2.25). Hypertension is common in the Malaysian adults. The control of hypertension has increased over the years but is still quite low. Public health measures, as well as individual interventions in primary care are crucial to reduce their risk of developing complications.

  6. On the Role of Aggregation Prone Regions in Protein Evolution, Stability, and Enzymatic Catalysis: Insights from Diverse Analyses

    PubMed Central

    Buck, Patrick M.; Kumar, Sandeep; Singh, Satish K.

    2013-01-01

    The various roles that aggregation prone regions (APRs) are capable of playing in proteins are investigated here via comprehensive analyses of multiple non-redundant datasets containing randomly generated amino acid sequences, monomeric proteins, intrinsically disordered proteins (IDPs) and catalytic residues. Results from this study indicate that the aggregation propensities of monomeric protein sequences have been minimized compared to random sequences with uniform and natural amino acid compositions, as observed by a lower average aggregation propensity and fewer APRs that are shorter in length and more often punctuated by gate-keeper residues. However, evidence for evolutionary selective pressure to disrupt these sequence regions among homologous proteins is inconsistent. APRs are less conserved than average sequence identity among closely related homologues (≥80% sequence identity with a parent) but APRs are more conserved than average sequence identity among homologues that have at least 50% sequence identity with a parent. Structural analyses of APRs indicate that APRs are three times more likely to contain ordered versus disordered residues and that APRs frequently contribute more towards stabilizing proteins than equal length segments from the same protein. Catalytic residues and APRs were also found to be in structural contact significantly more often than expected by random chance. Our findings suggest that proteins have evolved by optimizing their risk of aggregation for cellular environments by both minimizing aggregation prone regions and by conserving those that are important for folding and function. In many cases, these sequence optimizations are insufficient to develop recombinant proteins into commercial products. Rational design strategies aimed at improving protein solubility for biotechnological purposes should carefully evaluate the contributions made by candidate APRs, targeted for disruption, towards protein structure and activity. PMID

  7. Scheduling for Multifunction Radar via Two-Slope Benefit Functions

    DTIC Science & Technology

    2010-12-01

    planification des visées de suivi et de surveillance pour un radar multifonc- tion. Une technique séquentielle est proposée, selon laquelle on planifie...toutes les demandes de visées. On examine la planification des visées de suivi et de surveillance. Ces travaux proposent une méthode de planification ... planification anticipée et tardive. La méthode proposée pour établir l’ordre de priorité des visées de surveillance permet de réobserver des

  8. Valbenazine: First Global Approval.

    PubMed

    Kim, Esther S

    2017-07-01

    Valbenazine (Ingrezza™) is an orally bioavailable, selective, vesicular monoamine transporter 2 (VMAT2) inhibitor being developed by Neurocrine Biosciences for the treatment of various central nervous system disorders. Valbenazine has been approved in the USA for the treatment of adults with tardive dyskinesia (TD), is at various stages of development in other countries for TD and is in phase 2 development in the USA for Tourette syndrome. This article summarizes the milestones in the development of valbenazine leading to its first global approval in the USA for the treatment of adults with TD.

  9. Seasonal prediction of the typhoon genesis frequency over the Western North Pacific with a Poisson regression model

    NASA Astrophysics Data System (ADS)

    Zhang, Xinchang; Zhong, Shanshan; Wu, Zhiwei; Li, Yun

    2017-06-01

    This study investigates the typhoon genesis frequency (TGF) in the dominant season (July to October) in Western North Pacific (WNP) using observed data in 1965-2015. Of particular interest is the predictability of the TGF and associated preseason sea surface temperature (SST) in the Pacific. It is found that, the TGF is positively related to a tri-polar pattern of April SST anomalies in North Pacific (NP{T}_{Apr}), while it is negatively related to SST anomalies over the Coral Sea (CSS{T}_{Apr}) off east coast of Australia. The NP{T}_{Apr} leads to large anomalous cyclonic circulation over North Pacific. The anomalous southwesterly weakens the northeast trade wind, decreases evaporation, and induces warm water in central tropical North Pacific. As such, the warming effect amplifies the temperature gradient in central tropical North Pacific, which in turn maintains the cyclonic wind anomaly in the west tropical Pacific, which favors the typhoon genesis in WNP. In the South Pacific, the CSS{T}_{Apr} supports the typhoon formation over the WNP by (a) strengthening the cross-equatorial flows and enhancing the Inter-tropical Convergence Zone; (b) weakening southeast and northeast trade wind, and keeping continuous warming in the center of tropical Pacific. The influence of both NP{T}_{Apr} and CSS{T}_{Apr} can persistently affect the zonal wind in the tropical Pacific and induce conditions favorable for the typhoon genesis in the typhoon season. A Poisson regression model using NP{T}_{Apr} and CSS}{T}_{Apr} is developed to predict the TGF and a promising skill is achieved.

  10. Identification and Partial Characterization of Extracellular Aspartic Protease Genes from Metschnikowia pulcherrima IWBT Y1123 and Candida apicola IWBT Y1384

    PubMed Central

    Reid, Vernita J.; Theron, Louwrens W.; du Toit, Maret

    2012-01-01

    The extracellular acid proteases of non-Saccharomyces wine yeasts may fulfill a number of roles in winemaking, which include increasing the available nitrogen sources for the growth of fermentative microbes, affecting the aroma profile of the wine, and potentially reducing protein haze formation. These proteases, however, remain poorly characterized, especially at genetic level. In this study, two extracellular aspartic protease-encoding genes were identified and sequenced, from two yeast species of enological origin: one gene from Metschnikowia pulcherrima IWBT Y1123, named MpAPr1, and the other gene from Candida apicola IWBT Y1384, named CaAPr1. In silico analysis of these two genes revealed a number of features peculiar to aspartic protease genes, and both the MpAPr1 and CaAPr1 putative proteins showed homology to proteases of yeast genera. Heterologous expression of MpAPr1 in Saccharomyces cerevisiae YHUM272 confirmed that it encodes an aspartic protease. MpAPr1 production, which was shown to be constitutive, and secretion were confirmed in the presence of bovine serum albumin (BSA), casein, and grape juice proteins. The MpAPr1 gene was found to be present in 12 other M. pulcherrima strains; however, plate assays revealed that the intensity of protease activity was strain dependent and unrelated to the gene sequence. PMID:22820332

  11. Heterogeneity of heat-resistant proteases from milk Pseudomonas species.

    PubMed

    Marchand, Sophie; Vandriesche, Gonzalez; Coorevits, An; Coudijzer, Katleen; De Jonghe, Valerie; Dewettinck, Koen; De Vos, Paul; Devreese, Bart; Heyndrickx, Marc; De Block, Jan

    2009-07-31

    Pseudomonas fragi, Pseudomonas lundensis and members of the Pseudomonas fluorescens group may spoil Ultra High Temperature (UHT) treated milk and dairy products, due to the production of heat-stable proteases in the cold chain of raw milk. Since the aprX gene codes for a heat-resistant protease in P. fluorescens, the presence of this gene has also been investigated in other members of the genus. For this purpose an aprX-screening PCR test has been developed. Twenty-nine representatives of important milk Pseudomonas species and thirty-five reference strains were screened. In 42 out of 55 investigated Pseudomonas strains, the aprX gene was detected, which proves the potential of the aprX-PCR test as a screening tool for potentially proteolytic Pseudomonas strains in milk samples. An extensive study of the obtained aprX-sequences on the DNA and the amino acid level, however, revealed a large heterogeneity within the investigated milk isolates. Although this heterogeneity sets limitations to a general detection method for all proteolytic Pseudomonas strains in milk, it offers a great potential for the development of a multiplex PCR screening test targeting individual aprX-genes. Furthermore, our data illustrated the potential use of the aprX gene as a taxonomic marker, which may help in resolving the current taxonomic deadlock in the P. fluorescens group.

  12. [Pierre Chirac "premier physician" of the king and the aborted plan to create an "Académie de médecine" in Paris (1731-1732)].

    PubMed

    Lunel, Alexandre

    2005-03-01

    After being appointed "premier physician" in 1731, Pierre Chirac, thanks to his influence with the king, tried to realize an ambitious project. Inspired by the creation of an Academie de Chirurgie by the "premier surgeon", Chirac decided to creation an Académie de Médecine in Paris. Under his guidance, it was planned to collect opinions from all doctors of the kingdom in order to enhance global knowledge of disease, symptoms and treatments. However, threatened with the loss of its secular superiority, the Paris University Medical School immediately opposed the project. Although well advanced, the project was finally abandoned on Chirac's death.

  13. Differences in working conditions and employment arrangements among migrant and non-migrant workers in Europe.

    PubMed

    Ronda Pérez, Elena; Benavides, Fernando G; Levecque, Katia; Love, John G; Felt, Emily; Van Rossem, Ronan

    2012-01-01

    To determine migrant workers' exposure to select occupational risks and compare it with that of non-migrant workers in Europe. Based on the European Working Conditions Survey (EWCS-2005, n=29,654 workers, 31 countries) we examined differential prevalence amongst migrant and non-migrant workers' primary paid jobs in terms of employment arrangements (working >10 hours/day, working >5 days/week, on Sundays, without a contract, changes in the work schedule and not free to decide when to take holidays or days off) and working conditions (exposure to hazards including chemical, physical agents, physical load and psychological conditions). For the purpose of this study, a migrant is defined as a person without nationality of the country of residence (n=926). Adjusted prevalence ratios (aPRs) for age, economic sector and education were calculated. Differences in employment arrangements and working conditions were noted by migration status, gender and occupational status. Among non-manual workers, migrant males are more exposed than non-migrant males to negative psychosocial conditions--working at a very high speed (aPR 1.23; 95% CI 1.07-1.42) and shift work (aPR 1.66; 95% CI 1.27-2.17)--and adverse employment arrangements: working on Sundays (aPR 1.91; 95% CI 1.42-2.55), variable starting/finishing times (aPR 1.17; 95% CI 1.04-1.32) and changes in work schedule (aPR 1.56; 95% CI 1.30-1.88). Compared with non-migrant males, male migrant manual workers are the group with a greater number of disparities in terms of exposure to negative working conditions. Female migrant non-manual workers are more exposed to psychosocial conditions - working at very high speed (aPR 1.26; 95% CI 1.10-1.44) and shift work (aPR 1.61; 95% CI 1.29-2.01) while female manual migrant workers were more likely to report standing or walking (aPR 2.43; 95% CI 1.98-2.97), not having a contract (aPR 2.94; 95% CI 2.07-4.10) and not being free to decide days off and holidays (aPR 1.25; 95% CI 1.07-1.48) than

  14. In the Shadow of the Durand Line: Security, Stability, and the Future of Pakistan and Afghanistan

    DTIC Science & Technology

    2009-06-01

    130 From: “Balchistan: Terrorist Related Incidents,” http://satp.org/satporgtp/countries/pakistan/ Balochistan /index.html (accessed Apr 1, 2009...satporgtp/countries/pakistan/ Balochistan /index.html (accessed Apr 2, 2009). 59 60 and has over the years clearly operated covertly and overtly in...satporgtp/countries/pakistan/ Balochistan /index.html (accessed Apr 2, 2009). Balchistan: Terrorist Related Incidents. South Asian Terrorism Portal

  15. Prenatal exposure to systemic antibacterials and overweight and obesity in Danish schoolchildren: a prevalence study.

    PubMed

    Mor, A; Antonsen, S; Kahlert, J; Holsteen, V; Jørgensen, S; Holm-Pedersen, J; Sørensen, H T; Pedersen, O; Ehrenstein, V

    2015-10-01

    Prenatal exposure to antibacterials may permanently dysregulate fetal metabolic patterns via epigenetic pathways or by altering maternal microbiota. We examined the association of prenatal exposure to systemic antibacterials with overweight and obesity in schoolchildren. We conducted a prevalence study among Danish schoolchildren aged 7-16 years using data from routine school anthropometric evaluations conducted during 2002-2013. Prenatal exposure to antibacterials was ascertained by using maternal prescription dispensations and infection-related hospital admissions during pregnancy. We defined overweight and obesity among the children using standard age- and sex-specific cutoffs. We computed sex-specific adjusted prevalence ratios (aPRs) of overweight and obesity associated with exposure to prenatal antibacterials, adjusting for maternal age at delivery, marital status, smoking in pregnancy and multiple gestation; we also stratified the analyses by birth weight. Among 9886 schoolchildren, 3280 (33%) had prenatal exposure to antibacterials. aPRs associated with the exposure were 1.26 (95% confidence interval (CI): 1.10-1.45) for overweight and 1.29 (95% CI: 1.03-1.62) for obesity. Among girls, aPRs were 1.16 (95% CI: 0.95-1.42) for overweight and 1.27 (95% CI: 0.89 to 1.82) for obesity. Among boys, aPRs were 1.37 (95% CI: 1.13-1.66) for overweight and 1.29 (95% CI: 0.96-1.73) for obesity. The aPR for overweight was higher among schoolchildren with birth weight <3500 g (aPR: 1.30, 95% CI: 1.05-1.61) than in schoolchildren with birth weight ⩾3500 g (aPR: 1.18, 95% CI: 0.95-1.46). Inversely, the association for obesity was higher among schoolchildren with birth weight ⩾3500 g (aPR: 1.35, 95% CI: 1.00-1.81) than among those who were <3500 g at birth (aPR: 1.16, 95% CI: 0.82-1.65). Prenatal exposure to systemic antibacterials is associated with an increased risk of overweight and obesity at school age, and this association varies by birth weight.

  16. Human Tuberculosis Caused by Mycobacterium bovis in the United States, 2006-2013.

    PubMed

    Scott, Colleen; Cavanaugh, Joseph S; Pratt, Robert; Silk, Benjamin J; LoBue, Philip; Moonan, Patrick K

    2016-09-01

    Using genotyping techniques that have differentiated Mycobacterium bovis from Mycobacterium tuberculosis since 2005, we review the epidemiology of human tuberculosis caused by M. bovis in the United States and validate previous findings nationally. All tuberculosis cases with a genotyped M. tuberculosis complex isolate reported during 2006-2013 in the United States were eligible for analysis. We used binomial regression to identify characteristics independently associated with M. bovis disease using adjusted prevalence ratios (aPRs) and corresponding 95% confidence intervals (CIs). During 2006-2013, the annual percentages of tuberculosis cases attributable to M. bovis remained consistent nationally (range, 1.3%-1.6%) among all tuberculosis cases (N = 59 273). Compared with adults 25-44 years of age, infants aged 0-4 years (aPR, 1.9 [95% CI, 1.4-2.8]) and children aged 5-14 years (aPR, 4.0 [95% CI, 3.1-5.3]) had higher prevalences of M. bovis disease. Patients who were foreign-born (aPR, 1.4 [95% CI, 1.2-1.7]), Hispanic (aPR, 3.9 [95% CI, 3.0-5.0]), female (aPR, 1.4 [95% CI, 1.3-1.6]), and resided in US-Mexico border counties (aPR, 2.0 [95% CI, 1.7-2.4]) also had higher M. bovis prevalences. Exclusively extrapulmonary disease (aPR, 3.7 [95% CI, 3.3-4.2]) or disease that was both pulmonary and extrapulmonary (aPR, 2.4 [95% CI, 2.1-2.9]) were associated with a higher prevalence of M. bovis disease. Children, foreign-born persons, Hispanics, and females are disproportionately affected by M. bovis, which was independently associated with extrapulmonary disease. Targeted prevention efforts aimed at Hispanic mothers and caregivers are warranted. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  17. Plasma cholesterol homeostasis, HDL remodeling and function during the acute phase reaction.

    PubMed

    Zimetti, Francesca; De Vuono, Stefano; Gomaraschi, Monica; Adorni, Maria Pia; Favari, Elda; Ronda, Nicoletta; Ricci, Maria Anastasia; Veglia, Fabrizio; Calabresi, Laura; Lupattelli, Graziana

    2017-10-01

    Acute phase reaction (APR) is a systemic inflammation triggered by several conditions associated with lipid profile alterations. We evaluated whether APR also associates with changes in cholesterol synthesis and absorption, HDL structure, composition, and cholesterol efflux capacity (CEC). We analyzed 59 subjects with APR related to infections, oncologic causes, or autoimmune diseases and 39 controls. We detected no difference in markers of cholesterol synthesis and absorption. Conversely, a significant reduction of LpA-I- and LpAI:AII-containing HDL (-28% and -44.8%, respectively) and of medium-sized HDL (-10.5%) occurred in APR. Total HDL CEC was impaired in APR subjects (-18%). Evaluating specific CEC pathways, we found significant reductions in CEC by aqueous diffusion and by the transporters scavenger receptor B-I and ABCG1 (-25.5, -41.1 and -30.4%, respectively). ABCA1-mediated CEC was not affected. Analyses adjusted for age and gender provided similar results. In addition, correcting for HDL-cholesterol (HDL-C) levels, the differences in aqueous diffusion total and ABCG1-CEC remained significant. APR subjects displayed higher levels of HDL serum amyloid A (+20-folds; P = 0.003). In conclusion, APR does not associate with cholesterol synthesis and absorption changes but with alterations of HDL composition and a marked impairment of HDL CEC, partly independent of HDL-C serum level reduction. Copyright © 2017 by the American Society for Biochemistry and Molecular Biology, Inc.

  18. Folate, vitamin B12, and vitamin B6 status of a group of high socioeconomic status women in the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort.

    PubMed

    Fayyaz, Faiqa; Wang, Flora; Jacobs, René L; O'Connor, Deborah L; Bell, Rhonda C; Field, Catherine J

    2014-12-01

    Folic acid supplementation and food fortification policies have improved folate status in North American women of child bearing age. Recent studies have reported the possible inadequacy of vitamin B12 and B6 in the etiology of neural tube defects in folate-fortified populations. The aims of this study were to describe folate status and its relationship to supplementation and to assess vitamin B12 and B6 status in a cohort of pregnant women. Supplement intake data were collected in each trimester from the first cohort (n = 599) of the Alberta Pregnancy Outcomes and Nutrition (APrON) study. Red blood cell folate (RBCF) and plasma folate, holotranscobalamin, and pyridoxal 5-phosphate were measured. Overt folate deficiency was rare (3%) but 24% of women in their first trimester had suboptimal RBCF concentration (<906 nmol·L(-1)). The proportion of the cohort in this category declined substantially in second (9%) and third (7%) trimesters. High RBCF (>1360 nmol·L(-1)) was observed in approximately half of the women during each pregnancy trimester. Vitamin B12 and B6 deficiencies were rare (<1% of the cohort). Women consuming folic acid supplements above the upper level had significantly higher RBCF and plasma folate concentrations. In conclusion, the prevalence of vitamin B12 and B6 deficiency was very low. A quarter of the women had suboptimal folate status in the first trimester of pregnancy and over half the women had abnormally high RBCF, suggesting that supplementation during pregnancy is not appropriate in a cohort of women considered to be healthy and a low risk for nutritional deficiencies.

  19. Prevalence and correlates of insufficient physical activity in school adolescents in Peru.

    PubMed

    Sharma, Bimala; Chavez, Rosemary Cosme; Nam, Eun Woo

    2018-01-01

    OBJECTIVE To assess the prevalence and correlates of insufficient physical activity in adolescents in Peru. METHODS We used a self-administered questionnaire developed from Global school-based Student Health Survey to collect information from secondary school students in North Lima and Callao in 2015. We carried out Poisson regression with robust variance using generalized linear models to estimate the crude and adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) of insufficient physical activity for its correlates. RESULTS We have found that 78% of the adolescents did not meet the global recommendation of the World Health Organization on physical activity in the last week before the survey. Female respondents (APR = 1.13, 95%CI 1.04-1.21), respondents who perceived themselves as overweight (APR = 1.10, 95%CI 1.03-1.18), and respondents who consumed insufficient vegetables and fruits [no vegetables (APR = 1.30, 95%CI 1.06-1.59), no fruits (APR = 1.15, 95%CI 1.00-1.31) as compared to those who consumed ≥ 2 servings every day in the last seven days] were more likely to report insufficient physical activity. Adolescents who worked after school (APR = 0.92, 95%CI 0.84-0.99), had physical education classes five times per week (APR = 0.94, 95%CI 0.88-0.99), and had parental supervision (APR = 0.92, 95%CI 0.87-0.98) were less likely to report insufficient physical activity. CONCLUSIONS Sex, work after school, perceived body weight, physical education class, parental support, and healthy dietary behaviors were associated with insufficient physical activity. Attempts to improve physical activity should look for ways to enhance leisure-time physical activity, parental support, physical education classes, healthy dietary behaviors, and normal body weight maintenance in adolescents with integrated efforts from the family and school.

  20. Clinical Significance of Laboratory-determined Aspirin Poor Responsiveness After Primary Percutaneous Coronary Intervention.

    PubMed

    Mrdovic, Igor; Čolić, Mirko; Savic, Lidija; Krljanac, Gordana; Kruzliak, Peter; Lasica, Ratko; Asanin, Milika; Stanković, Sanja; Marinkovic, Jelena

    2016-04-01

    The objective of the present substudy was to examine whether aspirin poor/high responsiveness (APR/AHR) is associated with increased rates of major adverse cardiovascular events (MACE) and serious bleeding after primary percutaneous coronary intervention (PPCI). We analyzed 961 consecutive ST-elevation acute myocardial infarction patients who underwent PPCI between February 2008 and June 2011. Multiplate analyser (Dynabite, Munich, Germany) was used for the assessment of platelet reactivity. APR/AHR were defined as the upper/lower quintiles of ASPI values, determined 24 h after aspirin loading. APR patients were tailored using 300 mg maintenance dose for 30 days. The co-primary end points at 30 days were: MACE (death, non-fatal infarction, ischemia-driven target vessel revascularization and ischemic stroke) and serious bleeding according to the BARC classification. One hundred and 90 patients were classified as APR, and 193 patients as AHR. At admission, compared with aspirin sensitive patients (ASP), patients with APR had more frequently diabetes, anterior infarction and heart failure, while AHR patients had reduced values of creatine kinase, leukocytes, heart rate and systolic blood pressure. Compared with ASP, the rates of 30-day primary end points did not differ neither in APR group including tailored patients (MACE, adjusted OR 1.02, 95%CI 0.47-2.17; serious bleeding, adjusted OR 1.92, 95%CI 0.79-4.63), nor in patients with AHR (MACE, adjusted OR 1.58, 95%CI 0.71-5.51; serious bleeding, adjusted OR 0.69, 95%CI 0.22-2.12). The majority of APR patients were suitable for tailoring. Neither APR including tailored patients nor AHR were associated with adverse 30-day efficacy or safety clinical outcomes.

  1. Physical Functional Limitations among Aboriginal and Non-Aboriginal Older Adults: Associations with Socio-Demographic Factors and Health

    PubMed Central

    Gubhaju, Lina; Banks, Emily; MacNiven, Rona; McNamara, Bridgette J.; Joshy, Grace; Bauman, Adrian; Eades, Sandra J.

    2015-01-01

    Background Australian Aboriginal people are disproportionately affected by physical disability; the reasons for this are unclear. This study aimed to quantify associations between severe physical functional limitations and socio-demographic and health-related factors among older Aboriginal and non-Aboriginal adults. Methods Questionnaire data from 1,563 Aboriginal and 226,802 non-Aboriginal participants aged ≥45 years from the Sax Institute’s 45 and Up Study (New South Wales, Australia) were used to calculate age- and sex-adjusted prevalence ratios (aPRs) for severe limitation [MOS-PF score <60] according to socio-demographic and health-related factors. Results Overall, 26% (410/1563) of Aboriginal participants and 13% (29,569/226,802) of non-Aboriginal participants had severe limitations (aPR 2.8, 95%CI 2.5–3.0). In both Aboriginal and non-Aboriginal participants, severe limitation was significantly associated with: being ≥70 vs <70 years old (aPRs 1.8, 1.3–2.4 and 5.3, 5.0–5.5, within Aboriginal and non-Aboriginal participants, respectively), none vs tertiary educational qualifications (aPRs 2.4, 1.7–3.3 and 3.1, 3.0–3.2), lower vs higher income (aPRs 6.6, 4.2–10.5 and 5.5, 5.2–5.8), current vs never-smoking (aPRs 2.0, 1.6–2.5 and 2.2, 2.1–2.3), obese vs normal weight (aPRs 1.7, 1.3–2.2 and 2.7, 2.7–2.8) and sitting for ≥7 vs <7 hours/day (aPRs 1.6, 1.2–2.0 and 1.6, 1.6–1.7). Severe limitations increased with increasing ill-health, with aPRs rising to 5–6 for ≥5 versus no chronic conditions. It was significantly higher in those with few vs many social contacts (aPRs 1.7, 1.4–2.0 and 1.4, 1.4–1.4) and with very high vs low psychological distress (aPRs 4.4, 3.6–5.4 and 5.7, 5.5–5.9). Conclusions Although the prevalence of severe physical limitation among Aboriginal people in this study is around three-fold that of non-Aboriginal people, the factors related to it are similar, indicating that Aboriginal people have higher

  2. Associations between exposure to ambient benzene and PM(2.5) during pregnancy and the risk of selected birth defects in offspring.

    PubMed

    Tanner, Jean Paul; Salemi, Jason L; Stuart, Amy L; Yu, Haofei; Jordan, Melissa M; DuClos, Chris; Cavicchia, Philip; Correia, Jane A; Watkins, Sharon M; Kirby, Russell S

    2015-10-01

    A growing number of studies have investigated the association between air pollution and the risk of birth defects, but results are inconsistent. The objective of this study was to examine whether maternal exposure to ambient PM2.5 or benzene increases the risk of selected birth defects in Florida. We conducted a retrospective cohort study of singleton infants born in Florida from 2000 to 2009. Isolated and non-isolated birth defect cases of critical congenital heart defects, orofacial clefts, and spina bifida were identified from the Florida Birth Defects Registry. Estimates of maternal exposures to PM2.5 and benzene for all case and non-case pregnancies were derived by aggregation of ambient measurement data, obtained from the US Environmental Protection Agency Air Quality System, during etiologically relevant time windows. Multivariable Poisson regression was used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for each quartile of air pollutant exposure. Compared to the first quartile of PM2.5 exposure, higher levels of exposure were associated with an increased risk of non-isolated truncus arteriosus (aPR4th Quartile, 8.80; 95% CI, 1.11-69.50), total anomalous pulmonary venous return (aPR2nd Quartile, 5.00; 95% CI, 1.10-22.84), coarctation of the aorta (aPR4th Quartile, 1.72; 95% CI, 1.15-2.57; aPR3rd Quartile, 1.60; 95% CI, 1.07-2.41), interrupted aortic arch (aPR4th Quartile, 5.50; 95% CI, 1.22-24.82), and isolated and non-isolated any critical congenital heart defect (aPR3rd Quartile, 1.13; 95% CI, 1.02-1.25; aPR4th Quartile, 1.33; 95% CI, 1.07-1.65). Mothers with the highest level of exposure to benzene were more likely to deliver an infant with an isolated cleft palate (aPR4th Quartile, 1.52; 95% CI, 1.13-2.04) or any orofacial cleft (aPR4th Quartile, 1.29; 95% CI, 1.08-1.56). An inverse association was observed between exposure to benzene and non-isolated pulmonary atresia (aPR4th Quartile, 0.19; 95% CI, 0.04-0.84). Our

  3. Biological and social outcomes of antler point restriction harvest regulations for white-tailed deer

    USGS Publications Warehouse

    Wallingford, Bret D.; Diefenbach, Duane R.; Long, Eric S.; Rosenberry, Christopher S.; Alt, Gary

    2017-01-01

    Selective harvest criteria, such as antler point restrictions (APRs), have been used to regulate harvest of male ungulates; however, comprehensive evaluation of the biological and social responses to this management strategy is lacking. In 2002, Pennsylvania adopted new APRs for white-tailed deer (Odocoileus virginianus) that required, depending on wildlife management unit, ≥3 or ≥4 points on 1 antler for legal harvest. Historically, harvest rates of subadult (1.5 yr old) and adult (≥2.5 yr old) antlered males averaged 0.80. Antler point restrictions were designed to protect ≥50% of subadult males from harvest. Most adult males remained legal for harvest. We estimated harvest rates, survival rates, and cause-specific mortality of radio-collared male deer (453 subadults, 103 adults) in 2 wildlife management units (Armstrong and Centre counties) to evaluate biological efficacy of APRs to increase recruitment of adult males during 2002–2005. We administered statewide deer hunter surveys before and after each hunting season over the same 3 years to evaluate hunter attitudes toward APRs. We conducted 2 types of surveys: a simple random sample of all license buyers for each survey and a longitudinal panel of hunters who completed all 6 surveys. At the same time APRs were implemented, the Pennsylvania Game Commission (PGC) increased antlerless harvests to reduce deer density to meet deer management goals.Survival rates varied by month and age but not between study areas or among years after implementation of APRs. Monthly survival rates for subadults ranged from 0.64 to 0.97 during hunting seasons and 0.95 to 0.99 during the non-hunting period. Annual survival of subadults was 0.46 (95% CI = 0.41–0.52). Adult monthly survival rates ranged from 0.36 to 0.95 during hunting seasons and we had no mortalities during the non-hunting period. Annual survival of adults was 0.28 (95% CI = 0.22–0.35). Antler point restrictions successfully reduced harvest

  4. Oral health impacts of medications used to treat mental illness.

    PubMed

    Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J

    2017-12-01

    Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. VMAT2 Inhibitors and the Path to Ingrezza (Valbenazine).

    PubMed

    Harriott, Nicole D; Williams, John P; Smith, Evan B; Bozigian, Haig P; Grigoriadis, Dimitri E

    2018-01-01

    The dopaminergic system plays a key role in the central nervous system, regulating executive function, arousal, reward, and motor control. Dysregulation of this critical monoaminergic system has been associated with diseases of the central nervous system including schizophrenia, Parkinson's disease, and disorders such as attention deficit hyperactivity disorders and addiction. Drugs that modify the dopaminergic system by modulating the activity of dopamine have been successful in demonstrating clinical efficacy by providing treatments for these diseases. Specifically, antipsychotics, both typical and atypical, while acting on a number of monoaminergic systems in the brain, primarily target the dopamine system via inhibition of postsynaptic dopamine receptors. The vesicular monoamine transporter 2 (VMAT2) is an integral presynaptic protein that regulates the packaging and subsequent release of dopamine and other monoamines from neuronal vesicles into the synapse. Despite acting on opposing sides of the synapse, both antipsychotics and VMAT2 inhibitors act to decrease the activity of central dopaminergic systems. Tardive dyskinesia is a disorder characterized by involuntary repetitive movements and thought to be a result of a hyperdopaminergic state precipitated by the use of antipsychotics. Valbenazine (NBI-98854), a novel compound that selectively inhibits VMAT2 through an active metabolite, has been developed for the treatment of tardive dyskinesia and is the first drug approved for the treatment of this disorder. This chapter describes the process leading to the discovery of valbenazine, its pharmacological characteristics, along with preclinical and clinical evidence of its efficacy. © 2018 Elsevier B.V. All rights reserved.

  6. Improvement of Fibrinolytic Activity of Bacillus subtilis 168 by Integration of a Fibrinolytic Gene into the Chromosome.

    PubMed

    Jeong, Seon-Ju; Park, Ji Yeong; Lee, Jae Yong; Lee, Kang Wook; Cho, Kye Man; Kim, Gyoung Min; Shin, Jung-Hye; Kim, Jong-Sang; Kim, Jeong Hwan

    2015-11-01

    Fibrinolytic enzyme genes (aprE2, aprE176, and aprE179) were introduced into the Bacillus subtilis 168 chromosome without any antibiotic resistance gene. An integration vector, pDG1662, was used to deliver the genes into the amyE site of B. subtilis 168. Integrants, SJ3-5nc, SJ176nc, and SJ179nc, were obtained after two successive homologous recombinations. The integration of each fibrinolytic gene into the middle of the amyE site was confirmed by phenotypes (Amy(-), Spec(S)) and colony PCR results for these strains. The fibrinolytic activities of the integrants were higher than that of B. subtilis 168 by at least 3.2-fold when grown in LB broth. Cheonggukjang was prepared by inoculating each of B. subtilis 168, SJ3-5nc, SJ176nc, and SJ179nc, and the fibrinolytic activity of cheonggukjang was 4.6 ± 0.7, 10.8 ± 0.9, 7.0 ± 0.6, and 8.0 ± 0.2 (U/g of cheonggukjang), respectively at 72 h. These results showed that construction of B. subtilis strains with enhanced fibrinolytic activities is possible by integration of a strong fibrinolytic gene via a marker-free manner.

  7. Defense Standardization Program Journal. April/September 2012

    DTIC Science & Technology

    2012-01-01

    were magnified. In 1905, a committee of the National Fire Protection Association established a national standard for the diameter and threads per inch...for fire hydrants and hose couplings. The standard specifies that fire hydrants have 2.5-inch hose connections with 7.5 threads per inch and that...dsp.dla.mil I Field of view, lens material haze, luminous transmittance, and lens abrasion resistance (APR) I Communications (APR) I Fogging (APR

  8. Headlines Previous Editions

    Science.gov Websites

    Feb 2018 Jan 2018 Dec 2017 Nov 2017 Oct 2017 Sep 2017 Aug 2017 Jul 2017 Jun 2017 May 2017 APR 2017 MAR 2017 FEB 2017 JAN 2017 DEC 2016 NOV 2016 OCT 2016 SEP 2016 AUG 2016 JUL 2016 JUN 2016 MAY 2016 APR 2016 MAR 2016 FEB 2016 JAN 2016 DEC 2015 NOV 2015 OCT 2015 SEP 2015 AUG 2015 JUL 2015 JUN 2015 MAY 2015 APR

  9. USSR Report, Space

    DTIC Science & Technology

    1986-09-12

    8217Mir* (SOTSIALISTICHESKAYA INDUSTRIYA, 9 Apr 86) 31 Cosmonauts Perform Medical Exam With ’Gamma’ Apparatus (IZVESTIYA, 12 Apr 86) 32 b...8217Progress-26’ With ’Mir’ Station (VECHERNYAYA MOSKVA, 28 Apr 86) 37 TASS Reports Crew Unloading ’Progress-26’, Performing Visual Observations...Salyut-7) some 3,100 km away. The flight was performed by cosmonauts Leonid Kizim and Vladimir Solovyov. "The experiment is interesting from a

  10. Review of clinical and laboratory experiences with molindone hydrochloride.

    PubMed

    Claghorn, J L

    1985-08-01

    The literature concerning the pharmacokinetics, pharmacodynamics, receptor physiology, and clinical use of molindone is reviewed. Unanswered questions about the drug are addressed. Although molindone is reputed to have a short half-life (1.5 hours), clinical observations report a prolonged effect from a once-daily dose. Early in treatment, some patients show intolerance due to akathisia or extrapyramidal symptoms. This may be withdrawal dyskinesia due to discontinuation of another drug or an early adverse effect of molindone. Different effects on dopamine receptors have been described, but the significance of these properties for the development of tardive dyskinesia remains unclear.

  11. Hallucination: A rare complication of levetiracetam theraphy.

    PubMed

    Erdogan, Seher; Bosnak, Mehmet

    2017-01-01

    Levetiracetam is a new antiepileptic drug. In addition to epilepsy, it is also used for treating anxiety disorders and dystonia as well as tardive dyskinesia associated with the use of levodopa and neuroleptic drugs. Phenytoin therapy in a 10-year-old boy with convulsions was discontinued following cardiac rhythm impairment. The patient was then started on levetiracetam. However, visual and auditory hallucinations were observed on the 1st day of levetiracetam therapy. Levetiracetam was discontinued and replaced with sodium valproate, and the hallucinations resolved. The purpose of this report was to remind physicians that hallucinations are one of the rare complications of levetiracetam.

  12. Status of Breastfeeding and Child Immunization Outcomes in Clients of the Nurse-Family Partnership.

    PubMed

    Thorland, William; Currie, Dustin; Wiegand, Emily R; Walsh, Joe; Mader, Nick

    2017-03-01

    Background The Nurse-Family Partnership (NFP) is a home visiting program serving first-time, low-income mothers, with an area of focus on healthy early childhood development. Previous foundational trials of program effect on breastfeeding and immunizations have shown a mix of neutral and positive results. The present evaluation investigates these effects following program scale-up, using a large contemporary cohort of clients. Methods Nurse-Family Partnership client breastfeeding and immunization status were compared to National Survey of Children's Health data and National Immunization Survey data, respectively. Sample differences in demographic covariates were adjusted using logistic regression. Results Nurse-Family Partnership clients were significantly more likely to have ever breastfed (adjusted prevalence ratio [aPR: 1.20 (1.17, 1.23)] and maintain breastfeeding at 6 [aPR: 1.17 (1.10, 1.24)] and 12 [aPR: 1.39 (1.25, 1.53)] months, but less likely to exclusively breastfeed at 6 months [aPR: 0.84 (0.70, 0.95)] NFP clients were significantly more likely to be up-to-date on immunizations at 6 [aPR: 1.23 (1.22, 1.25)], 18 [aPR: 1.33 (1.30,1.35)], and 24 [aPR: 1.15 (1.14, 1.16)] months of age than the reference cohort, with no significant difference at 12 months. Discussion Nurse-Family Partnership clients had more beneficial breastfeeding and immunization outcomes than children of mothers with demographically similar profiles. However, exclusive breastfeeding at 6 months lags behind the reference sample and represents a potential area for further improvement.

  13. PIFCGT: A PIF autopilot design program for general aviation aircraft

    NASA Technical Reports Server (NTRS)

    Broussard, J. R.

    1983-01-01

    This report documents the PIFCGT computer program. In FORTRAN, PIFCGT is a computer design aid for determing Proportional-Integral-Filter (PIF) control laws for aircraft autopilots implemented with a Command Generator Tracker (CGT). The program uses Linear-Quadratic-Regulator synthesis algorithms to determine feedback gains, and includes software to solve the feedforward matrix equation which is useful in determining the command generator tracker feedforward gains. The program accepts aerodynamic stability derivatives and computes the corresponding aerodynamic linear model. The nine autopilot modes that can be designed include four maneuver modes (ROLL SEL, PITCH SEL, HDG SEL, ALT SEL), four final approach models (APR GS, APR LOCI, APR LOCR, APR LOCP), and a BETA HOLD mode. The program has been compiled and executed on a CDC computer.

  14. Index to Benet Weapons Laboratory (LCWSL) Technical Reports - 1984.

    DTIC Science & Technology

    1985-07-01

    construed as an official Department of the Army position unless so designated by other authorized documents. The use of trade name(s) and/or manufacture...Apr 84 System Autoloader D.E. Jones (BWL POC) ARLCB-CR-84011 Conceptual Autoloader Design B.D. Goodell Apr 84 Study for Future Armament System M.W... Design for 120mm J.E. Wildman Apr 84 Improved Conventional Armament D.E. Jones System (ICAS) Autoloader (BWL POC) ARLCB-MR-84013 Cadmium Plating vs

  15. Risk and Protective Factors for Difficulty Controlling Violent Behavior in National Guard and Reserve Service Members.

    PubMed

    Worthen, Miranda; Rathod, Sujit D; Cohen, Gregory; Sampson, Laura; Ursano, Robert; Gifford, Robert; Fullerton, Carol; Galea, Sandro; Ahern, Jennifer

    2017-11-01

    Violent behavior is an important problem for military service members and veterans. A representative cohort of U.S. Reserve and National Guard personnel ( N = 1,293) were interviewed to assess self-reported problems controlling violent behavior, deployment traumas, posttraumatic stress disorder (PTSD), alcohol abuse, and social support. Poisson regression models were used to estimate the associations of violent behavior with risk and protective factors. Problems controlling violent behavior were uncommon among male (3.3%) and female (1.7%) service members. Adjusted prevalence ratios (aPR) showed associations between violent behavior and deployment traumas (aPR = 1.67, 95% confidence interval [CI] = [1.34, 2.08]), PTSD (aPR = 9.95, 95% CI = [5.09, 19.48]), and PTSD symptom severity (aPR for each additional PTSD symptom = 1.07, 95% CI = [1.06, 1.09]). Social support was associated with lower prevalence of violent behavior (aPR = 0.62, 95% CI = [0.52, 0.76]). The association between violent behavior and alcohol abuse was not statistically significant (aPR = 1.94, 95% CI = [0.92, 4.09]). Results were consistent when the population was restricted to personnel who had deployed to a war zone. Problems controlling violent behavior were less common in this cohort than has been documented in other studies. Associations of violent behavior with risk and protective factors are consistent with prior research.

  16. The energetic cost of mounting an immune response for Pallas’s long-tongued bat (Glossophaga soricina)

    PubMed Central

    2018-01-01

    The acute phase response (APR) is the first line of defense of the vertebrate immune system against pathogens. Mounting an immune response is believed to be energetically costly but direct measures of metabolic rate during immune challenges contradict this assumption. The energetic cost of APR for birds is higher than for rodents, suggesting that this response is less expensive for mammals. However, the particularly large increase in metabolic rate after APR activation for a piscivorous bat (Myotis vivesi) suggests that immune response might be unusually costly for bats. Here we quantified the energetic cost and body mass change associated with APR for the nectarivorous Pallas’s long-tongued bat (Glossophaga soricina). Activation of the APR resulted in a short-term decrease in body mass and an increase in resting metabolic rate (RMR) with a total energy cost of only 2% of the total energy expenditure estimated for G. soricina. This increase in RMR was far from the large increase measured for piscivorous bats; rather, it was similar to the highest values reported for birds. Overall, our results suggest that the costs of APR for bats may vary interspecifically. Measurement of the energy cost of vertebrate immune response is limited to a few species and further work is warranted to evaluate its significance for an animal’s energy budget. PMID:29888121

  17. Accuracy of the all patient refined diagnosis related groups classification system in congenital heart surgery.

    PubMed

    Parnell, Aimee S; Shults, Justine; Gaynor, J William; Leonard, Mary B; Dai, Dingwei; Feudtner, Chris

    2014-02-01

    Administrative data are increasingly used to evaluate clinical outcomes and quality of care in pediatric congenital heart surgery (CHS) programs. Several published analyses of large pediatric administrative data sets have relied on the All Patient Refined Diagnosis Related Groups (APR-DRG, version 24) diagnostic classification system. The accuracy of this classification system for patients undergoing CHS is unclear. We performed a retrospective cohort study of all 14,098 patients 0 to 5 years of age undergoing any of six selected congenital heart operations, ranging in complexity from isolated closure of a ventricular septal defect to single-ventricle palliation, at 40 tertiary-care pediatric centers in the Pediatric Health Information Systems database between 2007 and 2010. Assigned APR-DRGs (cardiac versus noncardiac) were compared using χ2 or Fisher's exact tests between those patients admitted during the first day of life versus later and between those receiving extracorporeal membrane oxygenation support versus those not. Recursive partitioning was used to assess the greatest determinants of APR-DRG type in the model. Every patient admitted on day 1 of life was assigned to a noncardiac APR-DRG (p<0.001 for each procedure). Similarly, use of extracorporeal membrane oxygenation was highly associated with misclassification of CHS patients into a noncardiac APR-DRG (p<0.001 for each procedure). Cases misclassified into a noncardiac APR-DRG experienced a significantly increased mortality (p<0.001). In classifying patients undergoing CHS, APR-DRG coding has systematic misclassifications, which may result in inaccurate reporting of CHS case volumes and mortality. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Accuracy of the All Patient Refined Diagnosis Related Groups Classification System in Congenital Heart Surgery

    PubMed Central

    Parnell, Aimee S.; Shults, Justine; Gaynor, J. William; Leonard, Mary B.; Dai, Dingwei; Feudtner, Chris

    2015-01-01

    Background Administrative data is increasingly used to evaluate clinical outcomes and quality of care in pediatric congenital heart surgery (CHS) programs. Several published analyses of large pediatric administrative datasets have relied on the All Patient Refined Diagnosis Related Groups (APR-DRG, version 24) diagnostic classification system. The accuracy of this classification system for patients undergoing CHS is unclear. Methods We performed a retrospective cohort study of all 14,098 patients 0-5 years of age undergoing any of six selected congenital heart operations, ranging in complexity from isolated closure of a ventricular septal defect to single ventricle palliation, at 40 tertiary care pediatric centers in the Pediatric Health Information Systems database between 2007 and 2010. Assigned APR-DRGs (cardiac versus non-cardiac) were compared using chi-squared or Fisher's exact tests between those patients admitted during the first day of life versus later and between those receiving extracorporeal membrane oxygenation support versus not. Recursive partitioning was used to assess the greatest determinants of APR-DRG type in the model. Results Every patient admitted on day of life 1 was assigned to a non-cardiac APR-DRG (p < 0.001 for each procedure). Similarly, use of extracorporeal membrane oxygenation was highly associated with misclassification of congenital heart surgery patients into a non-cardiac APR-DRG (p < 0.001 for each procedure). Cases misclassified into a non-cardiac APR-DRG experienced a significantly increased mortality (p < 0.001). Conclusions In classifying patients undergoing congenital heart surgery, APR-DRG coding has systematic misclassifications, which may result in inaccurate reporting of CHS case volumes and mortality. PMID:24200398

  19. Protective Clothing. Part 1. Arctic and Tropical Environments (A Bibliography with Abstracts)

    DTIC Science & Technology

    1976-04-01

    75/377/2GSB Hydrogen Energy (86) Apr 75 NTIS/PS-75/379/8GSB Desulfurization of Coal and Petroleum (107) Apr 75 Excludes flue gas and other post...Petroleum (107) Apr 75 Excludes flue gas and other post-combustion sulfur con- trol NTIS/PS-75/381/4GSB Coal Gasification and Liquefaction. Vol 1... desulfurization NTIS/PS-75/455/6GSB Sulfur Dioxide Control . Vol 1. 1964-1972 (159) May 75 NTIS/PS-75/456/4GSB Activated Carbon (221) May 75

  20. The Association of Health Risk Behaviors and Training-Related Injury Among U.S. Army Basic Trainees

    DTIC Science & Technology

    2006-04-01

    717.7 Chondromalacia Of Patella; Degeneration of articular cartilage of patella 17-MAY-2003 1 719.46 Pain In Joint Involving Lower Leg 19-MAY-2003 I...Thera 7 I Example of diagnoses progression from pain to chondromalacia 18-APR-2003 I 0 1 719.46 Pain In Joint Involving Lower Leg 30-APR-2003· I 717.7... Chondromalacia of Patella; Degeneration of cartilage of patella 30-APR-2003 I V57.1 Other Physical Therapy 28 USACHPPM General Medical Service Study

  1. Comparative Effectiveness of Sphincter-Sparing Surgery versus Abdominoperineal Resection in Rectal Cancer: Patient-Reported Outcomes in National Surgical Adjuvant Breast and Bowel Project Randomized Trial R-04

    PubMed Central

    Russell, Marcia M.; Ganz, Patricia A.; Lopa, Samia; Yothers, Greg; Ko, Clifford Y.; Arora, Amit; Atkins, James N.; Bahary, Nathan; Soori, Gamini; Robertson, John M.; Eakle, Janice; Marchello, Benjamin T.; Wozniak, Timothy F.; Beart, Robert W.; Wolmark, Norman

    2015-01-01

    Objective NSABP R-04 was a randomized controlled trial of neoadjuvant chemoradiotherapy in patients with resectable stage II–III rectal cancer. We hypothesized that patients who underwent abdominoperineal resection (APR) would have a poorer quality of life than those who underwent sphincter-sparing surgery (SSS). Methods To obtain patient-reported outcomes (PROs) we administered two symptom scales at baseline and 1 year postoperatively: the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) and the European Organization for the Research and Treatment of Cancer module for patients with Colorectal Cancer Quality of Life Questionnaire (EORTC QLQ-CR38). Scoring was stratified by non-randomly assigned definitive surgery (APR vs SSS). Analyses controlled for baseline scores and stratification factors: age, gender, stage, intended surgery, and randomly assigned chemoradiotherapy. Results Of 1,608 randomly assigned patients, 987 had data for planned analyses; 62% underwent SSS; 38% underwent APR. FACT-C total and subscale scores were not statistically different by surgery at one year. For the EORTC-QLQ-CR38 functional scales, APR patients reported worse body image (70.3 vs 77.0, P=0.0005) at one year than did SSS patients. Males undergoing APR reported worse sexual enjoyment (43.7 vs 54.7, P=0.02) at one year than did those undergoing SSS. For the EORTC-QLQ-CR38 symptom scale scores, APR patients reported worse micturition symptoms than the SSS group at one year (26.9 vs 21.5, P=0.03). SSS patients reported worse GI tract symptoms than did the APR patients (18.9 vs 15.2, P<0.0001), as well as weight loss (10.1 vs 6.0, P=0.002). Conclusions Symptoms and functional problems were detected at one year by EORTC-QLQ-CR38, reflecting different symptom profiles in patients who underwent APR than those who underwent SSS. Information from these PROs may be useful in counseling patients anticipating surgery for rectal cancer. PMID:24670844

  2. Behaviors Associated With a Risk of HIV Transmission From HIV-Positive Street Youth to Non–Street Youth in Ukraine

    PubMed Central

    Nerlander, Lina M.C.; Zapata, Lauren B.; Yorick, Roman; Skipalska, Halyna; Smith, Ruben A.; Kissin, Dmitry M.; Jamieson, Denise J.; Vitek, Charles R.; Hillis, Susan D.

    2017-01-01

    Background Little is known about the extent to which HIV-infected street youth (living part or full time on the streets) exhibit behaviors associated with HIV transmission in their interactions with youth not living on the streets (“non–street youth”). We aimed to determine prevalences and predictors of such “bridging behaviors”: inconsistent condom use and needle sharing between HIV-positive street youth and non–street youth. Methods A total of 171 street youth in 3 Ukrainian cites were identified as HIV infected after testing of eligible participants aged 15 to 24 years after random selection of venues. Using data from these youth, we calculated prevalence estimates of bridging behaviors and assessed predictors using logistic regression. Results Overall, two-thirds of HIV-infected street youth exhibited bridging behaviors; subgroups with high prevalences of bridging included females (78.3%) and those involved in transactional sex (84.2%). In multivariable analysis, inconsistent condom use with non–street youth was associated with being female (adjusted prevalence ratio [aPR], 1.2; 95% confidence interval [CI], 1.1–1.4), working (aPR, 1.2; 95% CI, 1.03–1.4), multiple partners (aPR, 1.4; 95% CI, 1.2–1.6), and “never” (aPR, 1.4; 95% CI, 1.1–1.6) or “sometimes” (aPR, 1.3; 95% CI, 1.02–1.8) versus “always” sleeping on the street. Needle sharing with non–street youth was associated with being male (aPR, 1.4; 95% CI, 1.02–2.0), orphaned (aPR, 2.3; 95% CI, 1.8–3.0), and 2 years or less living on the streets (aPR, 1.8; 95% CI, 1.5–2.1). Conclusions Bridging behaviors between HIV-infected street youth and non–street youth are common. Addressing the comprehensive needs of street and other at-risk youth is a critical prevention strategy. PMID:26267878

  3. JPRS Report, China.

    DTIC Science & Technology

    1991-06-24

    52 Gross Industrial Output in April [CEI Database ...Jan-Apr Statistics on Payments to Employees [CEI Database ] ....................................................... 56 Jan-Apr Statistics on Labor...Productivity [CEI Database ] .............................................................. 56 TRANSPORTATION Hebei Province Opens Two Air Routes [HEBEI

  4. Records and Notes on Mosquitoes (Diptera: Culicidae) Collected in Egypt

    DTIC Science & Technology

    1988-01-01

    Ae. detritus. 117. El- Giza Gov., Saqqara, 1.5 km north of town at entrance to Zoser’s Pyramid (36RUU285053), 18 m; 22 Apr 1983. Plantation... Giza Gov., Saqqara, 1.6 km north of town at entrance to Zoser’s Pyramid (36RUU287055), 18 m; 22 Apr 1983. Plantation/cultivated area, medium-sized...unguiculata. 119. El- Giza Gov., Saqqara, 1 km from entrance to Zoser’s Pyramid (36RUU290054), 18 m; 22 Apr 1983. Plantation, small ditch at edge of

  5. Acute care surgery: defining mortality in emergency general surgery in the state of Maryland.

    PubMed

    Narayan, Mayur; Tesoriero, Ronald; Bruns, Brandon R; Klyushnenkova, Elena N; Chen, Hegang; Diaz, Jose J

    2015-04-01

    Emergency general surgery (EGS) is a major component of acute care surgery, however, limited data exist on mortality with respect to trauma center (TC) designation. We hypothesized that mortality would be lower for EGS patients treated at a TC vs non-TC (NTC). A retrospective review of the Maryland Health Services Cost Review Commission database from 2009 to 2013 was performed. The American Association for the Surgery of Trauma EGS ICD-9 codes were used to identify EGS patients. Data collected included demographics, TC designation, emergency department admissions, and All Patients Refined Severity of Illness (APR_SOI). Trauma center designation was used as a marker of a formal acute care surgery program. Primary outcomes included in-hospital mortality. Multivariable logistic regression analysis was performed controlling for age. There were 817,942 EGS encounters. Mean ± SD age of patients was 60.1 ± 18.7 years, 46.5% were males; 71.1% of encounters were at NTCs; and 75.8% were emergency department admissions. Overall mortality was 4.05%. Mortality was calculated based on TC designation controlling for age across APR_SOI strata. Multivariable logistic regression analysis did not show statistically significant differences in mortality between hospital levels for minor APR_SOI. For moderate APR_SOI, mortality was significantly lower for TCs compared with NTCs (p < 0.001). Among TCs, the effect was strongest for Level I TC (odds ratio = 0.34). For extreme APR_SOI, mortality was higher at TCs vs NTCs (p < 0.001). Emergency general surgery patients treated at TCs had lower mortality for moderate APR_SOI, but increased mortality for extreme APR_SOI when compared with NTCs. Additional investigation is required to better evaluate this unexpected finding. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Experiences with urine drug testing by police among people who inject drugs in Bangkok, Thailand.

    PubMed

    Hayashi, Kanna; Ti, Lianping; Buxton, Jane A; Kaplan, Karyn; Suwannawong, Paisan; Wood, Evan; Kerr, Thomas

    2014-03-01

    Thailand has relied on drug law enforcement in an effort to curb illicit drug use. While anecdotal reports suggest that Thai police frequently use urine toxicology to identify drug users, little is known about the prevalence or impacts of this practice among people who inject drugs (IDU). Therefore, we sought to examine experiences with urine drug testing by police among IDU in Bangkok. Data were derived from a community-recruited sample of IDU in Bangkok participating in the Mitsampan Community Research Project between July and October 2011. We assessed the prevalence and correlates of being subjected to urine toxicology testing by police using multivariate Poisson regression. In total, 438 IDU participated in this study, with 293 (66.9%) participants reporting having been tested for illicit drugs by police. In multivariate analyses, reports of drug testing by police were independently and positively associated with younger age (adjusted prevalence ratio [APR]: 1.28), a history of methamphetamine injection (APR: 1.22), a history of incarceration (APR: 1.21), having been in compulsory drug detention (APR: 1.43), avoiding healthcare (APR: 1.15), and HIV seropositivity (APR: 1.19), and negatively associated with access to voluntary drug treatment (APR: 0.82) (all p<0.05). A high proportion of IDU in Bangkok were subjected to drug testing by police. Young people and methamphetamine injectors were more likely to have been tested. The findings indicate that drug testing by police is associated with the compulsory drug detention system and may be interfering with IDU's access to healthcare and voluntary drug treatment. These findings raise concern about the widespread practice of drug testing by police and its associated impacts. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Escherichia coli contamination of child complementary foods and association with domestic hygiene in rural Bangladesh.

    PubMed

    Parvez, Sarker Masud; Kwong, Laura; Rahman, Musarrat Jabeen; Ercumen, Ayse; Pickering, Amy J; Ghosh, Probir K; Rahman, Md Zahidur; Das, Kishor Kumar; Luby, Stephen P; Unicomb, Leanne

    2017-05-01

    To determine the frequency and concentration of Escherichia coli in child complementary food and its association with domestic hygiene practices in rural Bangladesh. A total of 608 households with children <2 years were enrolled. We collected stored complementary food samples, performed spot checks on domestic hygiene and measured ambient temperature in the food storage area. Food samples were analysed using the IDEXX most probable number (MPN) method with Colilert-18 media to enumerate E. coli. We calculated adjusted prevalence ratios (APR) to assess the relationship between E. coli and domestic hygiene practices using modified Poisson regression, adjusting for clustering and confounders. Fifty-eight percentage of stored complementary food was contaminated with E. coli, and high levels of contamination (≥100 MPN/dry g food) were found in 12% of samples. High levels of food contamination were more prevalent in compounds where the food was stored uncovered (APR: 2.0, 95% CI: 1.2-3.2), transferred from the storage pot to the serving dish using hands (APR: 2.0, 95% CI: 1.3-3.2) or stored for >4 h (APR: 2.5, 95% CI: 1.5, 4.2), in compounds where water was unavailable in the food preparation area (APR: 2.6, 95% CI: 1.6, 4.2), where ≥1 fly was captured in the food preparation area (APR: 1.6, 95% CI: 1.0, 2.6), or where the ambient temperature was high (>25-40 °C) in the food storage area (APR: 2.7, 95% CI: 1.5, 4.4). Interventions to keep stored food covered and ensure water availability in the food preparation area would be expected to reduce faecal contamination of complementary foods. © 2017 John Wiley & Sons Ltd.

  8. Transnational Mortality Comparisons Between Archipelago and Mainland Puerto Ricans.

    PubMed

    Colón-Ramos, Uriyoán; Rodríguez-Ayuso, Idania; Gebrekristos, Hirut T; Roess, Amira; Pérez, Cynthia M; Simonsen, Lone

    2017-10-01

    Puerto Ricans in the US experience higher deaths from diabetes and other causes compared to non-Hispanic Whites and other Hispanic groups. We compared mortality in Puerto Rico to that of Puerto Ricans in the US as a first step to investigate if similar or worse mortality patterns originate from the sending country (Puerto Rico). Age-adjusted death rates were generated using national vital statistics databases in the US and territories for all-cause and the top ten causes of death among Hispanics in 2009. Mortality ratios in the archipelago of Puerto Rico (APR) were compared to mainland US Puerto Ricans (MPR). Rates for other ethnic/racial groups (Mexican Americans, Cubans, and non-Hispanic Whites, Blacks, American Indians, and Asians) were calculated to provide a context. APR had significantly higher all-cause mortality and death rates for diabetes, nephritis, pneumonia/influenza, and homicide/assault compared to MPR (APR/MPR ratio for all-cause: 1.08, diabetes: 2.04, nephritis: 1.84, pneumonia/influenza: 1.33, homicide/assault: 3.15). Death rates for diabetes and homicide/assault (particularly among men) were higher among APR compared to any other racial/ethnic groups in the US. In contrast, deaths from heart disease, cancer, and chronic liver disease were significantly lower for APR compared to MPR (MPR/APR ratio 0.72, 0.91, 0.41, respectively). Among APR women, death rates for these causes were also lower compared to any other group in the US. Substantial mortality variability exists between Puerto Ricans in Puerto Rico and those in the US, re-emphasizing the need to study of how socio-environmental determinants of health differ in sending and receiving countries. Explanations for disparate rates include access to and availability of healthcare and unique factors related to the migration experience of this group.

  9. Metabolic Cost of the Activation of Immune Response in the Fish-Eating Myotis (Myotis vivesi): The Effects of Inflammation and the Acute Phase Response

    PubMed Central

    Otálora-Ardila, Aída; Herrera M., L. Gerardo; Flores-Martínez, José Juan; Welch, Kenneth C.

    2016-01-01

    Inflammation and activation of the acute phase response (APR) are energetically demanding processes that protect against pathogens. Phytohaemagglutinin (PHA) and lipopolysaccharide (LPS) are antigens commonly used to stimulate inflammation and the APR, respectively. We tested the hypothesis that the APR after an LPS challenge was energetically more costly than the inflammatory response after a PHA challenge in the fish-eating Myotis bat (Myotis vivesi). We measured resting metabolic rate (RMR) after bats were administered PHA and LPS. We also measured skin temperature (Tskin) after the LPS challenge and skin swelling after the PHA challenge. Injection of PHA elicited swelling that lasted for several days but changes in RMR and body mass were not significant. LPS injection produced a significant increase in Tskin and in RMR, and significant body mass loss. RMR after LPS injection increased by 140–185% and the total cost of the response was 6.50 kJ. Inflammation was an energetically low-cost process but the APR entailed a significant energetic investment. Examination of APR in other bats suggests that the way in which bats deal with infections might not be uniform. PMID:27792729

  10. Metabolic Cost of the Activation of Immune Response in the Fish-Eating Myotis (Myotis vivesi): The Effects of Inflammation and the Acute Phase Response.

    PubMed

    Otálora-Ardila, Aída; Herrera M, L Gerardo; Flores-Martínez, José Juan; Welch, Kenneth C

    2016-01-01

    Inflammation and activation of the acute phase response (APR) are energetically demanding processes that protect against pathogens. Phytohaemagglutinin (PHA) and lipopolysaccharide (LPS) are antigens commonly used to stimulate inflammation and the APR, respectively. We tested the hypothesis that the APR after an LPS challenge was energetically more costly than the inflammatory response after a PHA challenge in the fish-eating Myotis bat (Myotis vivesi). We measured resting metabolic rate (RMR) after bats were administered PHA and LPS. We also measured skin temperature (Tskin) after the LPS challenge and skin swelling after the PHA challenge. Injection of PHA elicited swelling that lasted for several days but changes in RMR and body mass were not significant. LPS injection produced a significant increase in Tskin and in RMR, and significant body mass loss. RMR after LPS injection increased by 140-185% and the total cost of the response was 6.50 kJ. Inflammation was an energetically low-cost process but the APR entailed a significant energetic investment. Examination of APR in other bats suggests that the way in which bats deal with infections might not be uniform.

  11. [Associated Factors to non-use of Formal Health Services in the Peruvian Population: Analysis of the National Household Survey (ENAHO) 2015].

    PubMed

    Benites-Zapata, Vicente A; Lozada-Urbano, Michelle; Urrunaga-Pastor, Diego; Márquez-Bobadilla, Edith; Moncada-Mapelli, Enrique; Mezones-Holguín, Edward

    2017-01-01

    The aim of the study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors using the National Household Survey (ENAHO 2015). The participants were defined as NUHS if they have presented any symptoms, discomfort, illness, relapse of chronic illness or accident during the last month and did not go to the health services. 35036 participants were analyzed; the prevalence of NUHS was 53,9%. NUHS was higher in the coastal region (adjusted Prevalence Ratio [aPR]=1.24;95%CI:1.17-1.31), highlands (aPR=1.38; 95%CI: 1.31-1.46) and jungle (aPR=1.25,95%CI:1.18-1.33) compared to Lima. Likewise, there were a higher prevalence of NUHS in participants without health insurance (aPR=1.59;95%CI:1.52-1.66) and those affiliated to Ministry of Health insurance (aPR=1.16;95%CI:1.11-1.22) compared to those affiliated to Social Security. More than half of the participants suffered from NUHS, which was associated with geographical and health system conditions. It is required evidenced-informed public policies to improve this situation.

  12. Operation REDWING 1956

    DTIC Science & Technology

    1982-08-01

    AIRCRAFT UNIT Hq TAU 2 0 1 0 Eniwetok Is. 20 Mar Hq USAF Elm 0 4 0 0 Eniwetok Is. 30 Apr Hq USAF Elm 4 3 2 0 Parry Is. 30 Apr 4g Drop & Cann Elm 15 41 0...0 Eniwrv k Is. 1 5-36 16 Mar i 4 2 5-52 mqý Effects Elm 14 7 8 53 Eniwecck Is. 1 B-52 21 Mar 1 B-47 I B-57 1 B-66 2 F-84F 1 F-101 IBDA Elm 11 35 0 0...Eniwetok Is. 3 B-47 30 Apr Ionosphere Elm 6 12 0 0 Eniwetok Is. 1 C-97 30 Apr * "Navy Effects Elm 8 31 13 0 I A3D "I P2V Early Pe.ietr Elm 16 40 0 0

  13. Observations of solar flare photon energy spectra from 20 keV to 7 MeV

    NASA Technical Reports Server (NTRS)

    Yoshimori, M.; Watanabe, H.; Nitta, N.

    1985-01-01

    Solar flare photon energy spectra in the 20 keV to 7 MeV range are derived from the Apr. 1, Apr. 4, apr. 27 and May 13, 1981 flares. The flares were observed with a hard X-ray and a gamma-ray spectrometers on board the Hinotori satellite. The results show that the spectral shape varies from flare to flare and the spectra harden in energies above about 400 keV. Effects of nuclear line emission on the continuum and of higher energy electron bremsstrahlung are considered to explain the spectral hardening.

  14. Management of Munitions Constituents in Soil Using Alkaline Hydrolysis: A Guide for Practitioners

    DTIC Science & Technology

    2011-10-01

    Jan -05 Feb-05 Mar-05 Apr-05 R D X (m g) Control Treated distance in meters distance...soil RDX concentration by bay during the field demonstration (PL = post-lime). 0 2 4 6 8 10 12 Dec Dec (PL) Jan Mar Apr Apr (PL) Jul Oct (PL) Jan ... Jan (PL) Mar Jun Jun (PL) 2005 2006 2007 R D X C on ce nt ra tio n (m g/ kg ) Bay 2 (control) Bay 4 (limed) Study Date R D X C on ce nt ra tio

  15. Hallucination: A rare complication of levetiracetam theraphy

    PubMed Central

    Erdogan, Seher; Bosnak, Mehmet

    2017-01-01

    Levetiracetam is a new antiepileptic drug. In addition to epilepsy, it is also used for treating anxiety disorders and dystonia as well as tardive dyskinesia associated with the use of levodopa and neuroleptic drugs. Phenytoin therapy in a 10-year-old boy with convulsions was discontinued following cardiac rhythm impairment. The patient was then started on levetiracetam. However, visual and auditory hallucinations were observed on the 1st day of levetiracetam therapy. Levetiracetam was discontinued and replaced with sodium valproate, and the hallucinations resolved. The purpose of this report was to remind physicians that hallucinations are one of the rare complications of levetiracetam. PMID:29270577

  16. Meteorological Techniques (Revision 26 Apr 2006)

    DTIC Science & Technology

    2003-06-13

    OVV Graph ------------------------------------------------------------------------ 2-11 Figure 2-26 Dissipation of Stratus Using Mixing Ratio and...2-51 Figure 2-70 Bright Band Identification Using the WSR-88D. ------------------------------------------ 2-52 Figure 2-71 Example of Visible...R2, and R3 relative humidity values and cloud amounts ------------------------- 2-7 Table 2-4 Base of convective clouds using surface dew-point

  17. FY 2017 Annual Performance Report (APR)

    EPA Pesticide Factsheets

    Presents detailed performance results, as measured against the targets established in EPA’s FY 2017 Annual Plan and Budget. The Executive Overview section analyzes key performance outcomes and links to FY 2017 program evaluations.

  18. IRIS Bimonthly Public Meeting (Apr 2014)

    EPA Pesticide Factsheets

    EPA hosted a public meeting/webinar to provide an opportunity for the public to give input and participate in an open discussion regarding several IRIS chemical assessments for Diethyl Phthalate (DEP) and Hexabromocyclododecane (HBCD).

  19. 48 CFR 212.7002-1 - Contracts under the program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... item or process that does not meet the definition of “commercial item,” if the contract— (1) Is awarded... computer software. [69 FR 63330, Nov. 1, 2004, as amended at 71 FR 18669, Apr. 12, 2006; 73 FR 21845, Apr...

  20. 48 CFR 212.7002-1 - Contracts under the program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... item or process that does not meet the definition of “commercial item,” if the contract— (1) Is awarded... computer software. [69 FR 63330, Nov. 1, 2004, as amended at 71 FR 18669, Apr. 12, 2006; 73 FR 21845, Apr...

  1. 48 CFR 212.7002-1 - Contracts under the program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... item or process that does not meet the definition of “commercial item,” if the contract— (1) Is awarded... computer software. [69 FR 63330, Nov. 1, 2004, as amended at 71 FR 18669, Apr. 12, 2006; 73 FR 21845, Apr...

  2. 48 CFR 212.7002-1 - Contracts under the program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... item or process that does not meet the definition of “commercial item,” if the contract— (1) Is awarded... computer software. [69 FR 63330, Nov. 1, 2004, as amended at 71 FR 18669, Apr. 12, 2006; 73 FR 21845, Apr...

  3. Expression and characterization of Coprothermobacter proteolyticus alkaline serine protease

    USDA-ARS?s Scientific Manuscript database

    TECHNICAL ABSTRACT A putative protease gene (aprE) from the thermophilic bacterium Coprothermobacter proteolyticus was cloned and expressed in Bacillus subtilis. The enzyme was determined to be a serine protease based on inhibition by PMSF. Biochemical characterization demonstrated the enzyme had...

  4. La NLPC en décubitus dorsal modifié : notre expérience.

    PubMed

    El Harrech, Youness; Ghoundale, Omar; Zaini, Rachid; Moufid, Kamal; Touiti, Driss

    2011-08-01

    RéSUMé: INTRODUCTION ET OBJECTIF :: La NLPC est conventionnellement réalisée en décubitus ventral. Cette position présente de nombreux inconvénients. Notre objectif était d'évaluer de façon prospective le caractère sûr et efficace de la NLPC en position de décubitus dorsal modifié (DDM). MATéRIEL ET MéTHODES :: Entre novembre 2004 et janvier 2010, 159 NLPC ont été réalisées en DDM. Le patient a été mis en décubitus dorsal avec un billot sous le flanc permettant une rotation de 45 degrés du côté opposé. Une position de lithotomie modifiée était associée si un double accès antérograde et rétrograde simultané était nécessaire. Après ponction rénale, la dilatation a été faite selon la technique « one shot » ou en utilisant les dilatateurs d'Alken. Les caractéristiques des patients et des calculs, la durée opératoire, le séjour hospitalier, les complications et le taux d'absence de calculs résiduels (« stone free ») ont été analysés. RéSULTATS :: L'âge moyen des patients était de 47 ± 13,1 ans (22-70). Vingt-et-un patients avaient des ATCD de chirurgie rénale du même côté. Vingt-six patients avaient un rein unique anatomique ou fonctionnel. Un patient avait un rein en fer à cheval et deux patients avaient une malrotation rénale. Le diamètre moyen des calculs était de 3,4 ± 1,9 cm (1,3-5,4) et 20 patients avaient des calculs coralliformes. Dix patients avaient des calculs urétéraux et ont eu une urétéroscopie simultanée. La durée moyenne de l'intervention était de 60 ± 29 min. Deux interventions ont été interrompues en raison d'un saignement important. Trois cas de fièvre postopératoire et 2 cas de fistule urinaire traités par sonde en double J ont été notés. Aucune plaie vasculaire ou viscérale n'a été rapportée ni de plaie pleuropulmonaire. Huit patients ont eu une seconde séance de NLPC durant la même hospitalisation. Après trois mois le taux d'absence de calculs résiduels

  5. Scoring of medical publications with SIGAPS software: Application to orthopedics.

    PubMed

    Rouvillain, J-L; Derancourt, C; Moore, N; Devos, P

    2014-11-01

    SIGAPS is a bibliometric software tool developed in France to identify and analyze Medline-indexed publications that are produced by a researcher or research group. This measurement takes into account the author's ranking on the paper along with the journal's prestige according to its impact factor within the research field. However, use of this impact factor is the primary limitation of SIGAPS. SIGAPS analysis results are used to assign a financial value to hospital facilities. The impact of the journal Revue de Chirurgie Orthopédique and its successor-Orthopaedics & Traumatology: Surgery & Research-was compared using the Medline-based ISI (SIGAPS) and SCOPUS-based SCImago journal rankings. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Differences in risk behaviours and HIV/STI prevalence between low-fee and medium-fee female sex workers in three provinces in China.

    PubMed

    Han, Lifeng; Zhou, Chu; Li, Zhijun; Poon, Adrienne N; Rou, Keming; Fuller, Serena; Li, Yan; Shen, Limei; Kang, Dianmin; Huang, Lu; Liao, Meizhen; Fu, Xiaobing; Shepard, Colin; Wu, Zunyou; Bulterys, Marc

    2016-06-01

    To better understand risk behaviours and factors associated with low-fee female sex workers (FSW) and support HIV/sexually transmitted infections (STI) epidemic control among this key population in China. A cross-sectional study using convenience sampling to recruit 1487 eligible low-fee and medium-fee FSW was conducted in 2012 in three provinces. The participants were interviewed using a structured questionnaire and tested for HIV-1, herpes simplex virus (HSV)-2 and syphilis antibody. Log-binomial modelling was used to estimate prevalence ratios (PR) and examine factors associated with low-fee sex work. Prevalence of HIV-1, syphilis and HSV-2 antibody positive were 0.5%, 4.8% and 27.8%, respectively. Low-fee FSW were more likely to have HSV-2 infection (adjusted prevalence ratio (APR)=1.3, 95% CI 1.1 to 1.7), but not more likely to have HIV-1 and syphilis infection compared with medium-fee FSW. Compared with medium-fee FSW, low-fee FSW were more likely to be ≥35 years of age (APR=2.1, 95% CI 1.3 to 3.6), engage in sex work ≥6 days/per week (APR=1.7, 95% CI 1.2 to 2.6), have ≥3 clients per day (APR=2.2, 95% CI 1.5 to 3.3), have clients decide condom use (APR=1.6, 95% CI 1.1 to 2.3), fail to persuade clients to use condoms (APR=1.6, 95% CI 1.1 to 2.6), express willingness to have unprotected sex in return for receipt of a higher fee (APR=1.8, 95% CI 1.2 to 2.8), have had genital symptoms in the past year (APR=1.4, 95% CI 1.1 to 1.8) and have migrated from another city. Low-fee FSW in China have unique risks for acquiring HIV/STI, in part due to greater economic pressures. Tailored interventions targeting low-fee FSW and incorporating their prevailing perception of HIV/STI risks and condom use negotiation challenges that they face are urgently needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. ROLE OF THE MATERNAL ACUTE PHASE RESPONSE AND TUMOR NECROSIS FACTOR ALPHA IN THE DEVELOPMENTAL TOXICITY OF LIPOPOLYSACCHARIDE IN THE CD-1 MOUSE

    EPA Science Inventory

    ABSTRACT
    The acute phase response (APR) functions to reset metabolic homeostasis following infectious, toxic or traumatic insult. TNF- , a putative mediator of the APR, has been associated with fetal death in rodents and preterm labor and delivery in humans. We hypothesized...

  8. --No Title--

    Science.gov Websites

    -August July-September Sep-Oct Oct-Nov Nov-Dec Dec-Jan Jan-Feb Feb-Mar Mar-Apr Apr-May May-Jun Aug-Sep -January December-February January-March February-April March-May April-Jun May-July June-August July

  9. Polar Vortex Dynamics During Spring and Fall Diagnosed Using ATMOS Trace Gas Observation

    NASA Technical Reports Server (NTRS)

    Manney, G.; Michelsen, H.; Santee, M.; Gunson, M.; Irion, F.; Roche, A.; Livesey, N.

    1999-01-01

    Trace gases measured by the Atmospheric Trace Molecule Spectroscopy (ATMOS) instrument during the Mar/Apr 1992(AT-1), Apr 1993(AT-2), and Nov 1994(AT-3) space-shuttle missions have been mapped into equivalent latitude/potential temperature (EqL/0) coordinates.

  10. Increases in the serum acute phase proteins after ozone exposure are associated with induction of genes in the lung but not liver

    EPA Science Inventory

    Acute Phase Response (APR), a systemic reaction to infection, trauma, and inflammation, is characterized by increases and decreases in plasma levels of positive and negative acute phase proteins (APP), respectively. Although the liver has been shown to contribute to APR in variou...

  11. Associations between the prevalence of influenza vaccination and patient's knowledge about antibiotics: a cross-sectional study in the framework of the APRES-project in Austria.

    PubMed

    Hoffmann, Kathryn; van Bijnen, Evelien Me; George, Aaron; Kutalek, Ruth; Jirovsky, Elena; Wojczewski, Silvia; Maier, Manfred

    2015-09-29

    This study aimed to identify associations between GP patient's knowledge about the spectrum of effectiveness of antibiotics and the probability of vaccination against influenza. The underlying hypothesis was that individuals with an understanding that antibiotics are ineffective against viruses, common colds, and flu were more likely to be vaccinated than persons lacking this knowledge. This cross-sectional study was conducted within the context of the European APRES project in Austria. Between November 2010 and July 2011, patients were recruited from GP practices to complete questionnaires about their knowledge about antibiotics and their influenza vaccination status. Statistical analyses included subgroup analyses and logistic regression models. Data of 3224 patients was analyzed, demonstrating that patients with better knowledge concerning antibiotics had a significantly higher likelihood of being vaccinated (OR 1.35, CI 95 % 1.18-1.54). While the overall vaccination rate was low (18.6 % in 2009/2010 and 14.0 % in 2010/2011), elderly compared to younger adults (OR 0.06 CI 95 % 0.03-0.13) and healthcare workers (OR 2.24, CI 95 % 1.42-3.54) demonstrated higher likelihood of vaccination. Additionally, female GPs had significantly more vaccinated patients than male GPs (OR 2.90, CI 95 % 1.32-6.40). There has been little prior study on the association between a patient's knowledge of the effectiveness spectrum of antibiotics and influenza vaccination status. Given the public health imperative to increase annual prevalence of influenza vaccination, understanding this educational gap can improve specificity in counseling as well as vaccination rates. Ultimately, we found that those with a better knowledge on about antibiotics had a significantly higher likelihood of being vaccinated. The results of this study demonstrate that vaccination prevalence is associated with patient's knowledge about antibiotics. It can be concluded that one strategy to improve the overall low

  12. Tomographie par coherence optique pour le guidage de chirurgies minimalement invasives du rachis

    NASA Astrophysics Data System (ADS)

    Beaudette, Kathy

    Adolescent idiopathic scoliosis is a complex 3D deformity of the spine which requires surgical intervention in severe cases of the condition. The existing corrective procedure of scoliosis is very invasive; it involves a long incision and a large instrumentation, in addition to the fusion of a section of the spine. To improve postoperative conditions and to preserve patients' spinal flexibility, novel fusionless surgical approaches involving growth modulation are under investigation. With this objective in mind, a multidisciplinary team from École Polytechnique of Montreal and Sainte-Justine University Hospital Research Center is developing a surgical technique based on the insertion of micro-staples between vertebral growth plates and corresponding intervertebral disks. Each micro-staple passively modulates the vertebral growth on the convex side of the scoliotic curvature. This modulation modifies vertebral geometry which, for scoliotic patients, presents a wedging deformity. The modulation induced by these devices could lead to the correction of the curvature of the spine. This innovative procedure would preserve the flexibility of the spine as well as the health of intervertebral disks, in addition to being compatible with minimally invasive approaches. However, to be efficient, the micro-staples must be placed at the junction between the growth plate and the disk with a sub-millimeter precision. An intraoperative guiding system is therefore required to ensure the success of the intervention. Optical coherence tomography (OCT) is a promising candidate for this application. OCT is based on low-coherence interferometry and provides cross-sectional images with a resolution about 10 μm for a depth of 2 to 3 mm. This technique allows for the real-time acquisition of images and is compatible with endoscopy, thereby showing a potential for the intraoperative guidance of minimally invasive surgeries (MIS) of the spine. The main objective of this master's project is therefore to evaluate the possibility of using OCT to localize as well as identify spinal structures (such as growth plates, osseous tissue, intervertebral disks and connective tissue) and to guide the insertion of micro-staples. To attain this objective, an OCT handheld probe was designed and developed according to the surgical constraints of MIS performed by thoracoscopy (through the thorax). This probe has an external diameter of 17 mm and is 30 cm long. Coupled with a fibered interferometer, the axial and lateral resolutions of the probe are of 16 and 27 μm respectively. The OCT probe was used in vivo during an open surgery on a porcine model. Different tissues within the operative window (lung, muscles, osseous tissues and intervertebral disk) were imaged during the procedure. These preliminary in vivo tests demonstrated that the probe is capable of identifying different types of tissue with a good sensitivity and an adequate penetration depth. These results also showed that a visual inspection of the in vivo OCT images alone is not sufficient to localize the growth plates on the vertebrae. An ex vivo study using porcine vertebrae was therefore performed to identify quantitative markers in order to facilitate the interpretation of in vivo OCT images. OCT images were initially compared to corresponding histological sections. The ensuing results showed that the connective tissue layer presents a band pattern due to the birefringence properties of the collagen-rich tissue. The intervertebral disk was also shown to have a characteristic lamellar structure on OCT images. Lastly, within growth plate and osseous tissue locations, the OCT signal decay is monotonic, but with different attenuation coefficients (different slopes). Relative attenuation coefficients were therefore measured for each tissue (growth plate, osseous tissue, connective tissue and intervertebral disk) on several specimens and were compared. These results showed that growth plates present an average relative attenuation coefficient statistically different from the other tissues. An automatic growth plate segmentation algorithm was then developed and tested. The algorithm was applied to images from an ex vivo specimen of a porcine vertebra and successfully identified most of the growth plate (> 75%) amidst the osseous tissue of the vertebral body and the intervertebral disk. This master's project shows that OCT presents contrast, resolution and penetration depth that are sufficient for the identification of musculoskeletal structures of the spine. It is thus reasonable to believe that, ultimately, OCT could be used for the intraoperative guiding of the insertion of micro-staples during corrective surgeries of scoliosis.

  13. 76 FR 55237 - Use of Derivatives by Investment Companies Under the Investment Company Act of 1940

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-07

    ... years, the use of derivatives by mutual funds has soared.''), available at http://www.interactivedata... Companies, Investment Company Act Release No. 10666 (Apr. 18, 1979) (``Release 10666'') [44 FR 25128 (Apr. 27, 1979)], and Registered Investment Company Use of Senior Securities-Select Bibliography (``Senior...

  14. Distribution Assessments of Coumarins from Angelicae Pubescentis Radix in Rat Cerebrospinal Fluid and Brain by Liquid Chromatography Tandem Mass Spectrometry Analysis.

    PubMed

    Yang, Yan-Fang; Zhang, Lei; Yang, Xiu-Wei

    2018-01-20

    Angelicae Pubescentis Radix (APR) is a widely-used traditional Chinese medicine. Pharmacological studies have begun to probe its biological activities on neurological disorders recently. To assess the brain penetration and distribution of APR, a validated ultra-performance liquid chromatography tandem mass spectrometry method was applied to the simultaneous determinations of the main coumarins from APR in the rat cerebrospinal fluid (CSF) and brain after oral administration of APR extract, including psoralen, xanthotoxin, bergapten, isoimperatorin, columbianetin, columbianetin acetate, columbianadin, oxypeucedanin hydrate, angelol B, osthole, meranzin hydrate and nodakenetin. Most of the tested coumarins entered the rat CSF and brain quickly, and double-peak phenomena in concentration-time curves were similar to those of their plasma pharmacokinetics. Columbianetin had the highest concentration in the CSF and brain, while psoralen and columbianetin acetate had the largest percent of CSF/plasma and brain/plasma, indicating that these three coumarins may be worthy of further research on the possible nervous effects. Correlations between the in vivo brain distributions and plasma pharmacokinetics of these coumarins were well verified. These results provided valuable information for the overall in vivo brain distribution characteristics of APR and also for its further studies on the active substances for the central nervous system.

  15. RNG1 is a Late Marker of the Apical Polar Ring in Toxoplasma gondii

    PubMed Central

    Tran, Johnson Q.; de Leon, Jessica C.; Li, Catherine; Huynh, My-Hang; Beatty, Wandy; Morrissette, Naomi S.

    2010-01-01

    The asexually proliferating stages of apicomplexan parasites cause acute symptoms of diseases such as malaria, cryptosporidiosis and toxoplasmosis. These stages are characterized by the presence of two independent microtubule organizing centers (MTOCs). Centrioles are found at the poles of the intranuclear spindle. The apical polar ring (APR), a MTOC unique to apicomplexans, organizes subpellicular microtubules which impose cell shape and apical polarity on these protozoa. Here we describe the characteristics of a novel protein that localizes to the APR of Toxoplasma gondii which we have named ring-1 (RNG1). There are related RNG1 proteins in Neospora caninum and Sarcocystis neurona but no obvious homologs in Plasmodium spp., Cryptosporidium spp. or Babesia spp. RNG1 is a small, low-complexity, detergent-insoluble protein that assembles at the APR very late in the process of daughter parasite replication. We were unable to knock-out the RNG1 gene, suggesting that its gene product is essential. Tagged RNG1 lines have also allowed us to visualize the APR during growth of Toxoplasma in the microtubule-disrupting drug oryzalin. Oryzalin inhibits nuclear division and cytokinesis although Toxoplasma growth continues, and similar to earlier observations of unchecked centriole duplication in oryzalin-treated parasites, the APR continues to duplicate during aberrant parasite growth. PMID:20658557

  16. Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units.

    PubMed

    Meneses, Tatiana Mota Xavier de; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira

    To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted prevalence ratios (APR) by Poisson regression with robust variance. The final model included the variables associated with breast milk donation (p≤0.05). 7.3% of the mothers had donated breast milk. Having been encouraged to donate breast milk by healthcare professionals, relatives, or friends (APR=7.06), receiving information on breast milk expression by the primary health care unit (APR=3.65), and receiving help from the unit professionals to breastfeed (APR=2.24) were associated with a higher prevalence of donation. Admission of the newborn to the neonatal unit was associated with a lower prevalence of donation (APR=0.09). Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation. Copyright © 2017. Published by Elsevier Editora Ltda.

  17. Atmospheric temperature and pressure influence the onset of spontaneous pneumothorax.

    PubMed

    Motono, Nozomu; Maeda, Sumiko; Honda, Ryumon; Tanaka, Makoto; Machida, Yuichiro; Usuda, Katsuo; Sagawa, Motoyasu; Uramoto, Hidetaka

    2018-02-01

    The aim of the study was to examine the influence of the changes in the atmospheric temperature (ATemp) and the atmospheric pressure (APres) on the occurrence of a spontaneous pneumothorax (SP). From January 2000 to March 2014, 192 consecutive SP events were examined. The ATemp and APres data at the onset of SP, as well as those data at 12, 24, 36, 48, 60, and 72 h prior to the onset time, were analyzed. The frequencies of SP occurrence were not statistically different according to the months or seasons, but were statistically different according to the time period (P < .01) and SP events occurred most frequently from 12:00 to 18:00. SP events frequently occurred at an ATemp of 25 degrees Celsius or higher. There was a significantly negative correlation between the APres and the ATemp at the SP onset time. The values of change in the APres from 36 to 24 h prior to SP onset were significantly lower than the preceding values. In this study, we observed that a SP event was likely to occur in the time period from 12:00 to 18:00, at an ATemp of 25 degrees Celsius or higher, and at 24-36 h after a drop of APres. © 2016 John Wiley & Sons Ltd.

  18. Genomic selection for quantitative adult plant stem rust resistance in wheat

    USDA-ARS?s Scientific Manuscript database

    Quantitative adult plant resistance (APR) to stem rust (Puccinia graminis f. sp. tritici) is an important breeding target in wheat (Triticum aestivum L.) and a potential target for genomic selection (GS). To evaluate the relative importance of known APR loci in applying genomic selection, we charact...

  19. Lifting the weight of a diagnosis-related groups family change: a comparison between refined and non-refined DRG systems for top-down cost accounting and efficiency indicators.

    PubMed

    Zlotnik, Alexander; Cuchi, Miguel Alfaro; Pérez Pérez, Maria Carmen

    Public healthcare providers in all Spanish Regions - Autonomous Communities (ACs) use All Patients Diagnosis-Related Groups (AP-DRGs) for billing non-insured patients, cost accounting and inpatient efficiency indicators. A national migration to All Patients Refined Diagnosis-Related Groups (APR-DRGs) has been scheduled for 2016. The analysis was performed on 202,912 inpatient care episodes ranging from 2005 to 2010. All episodes were grouped using AP-DRG v25.0 and APR-DRG v24.0. Normalised DRG weight variations for an AP-DRG to APR-DRG migration scenario were calculated and compared. Major differences exist between normalised weights for inpatient episodes depending on the DRGs family used. The usage of the APR-DRG system in Spain without any adjustments, as it was developed in the United States, should be approached with care. In order to avoid reverse incentives and provider financial risks, coding practices should be reviewed and structural differences between DRG families taken into account.

  20. What predicts support for antler point restrictions?

    USGS Publications Warehouse

    Schroeder, Susan A.; Cornicelli, Louis; Fulton, David C.; Grund, Marrett D.

    2014-01-01

    Although considerable research has focused on satisfaction with recreation experiences, limited work has examined factors related to regulatory support. In 2005, an antler point restriction (APR) regulation was introduced for hunting white-tailed deer (Odocoileus virginianus) in Minnesota’s Itasca State Park. Hunter surveys were conducted following the 2005, 2006, 2007, and 2009 seasons. We modeled how (a) satisfaction with the deer seen, (b) type of deer pursued, (c) agency trust, and (d) years of deer-hunting experience, influenced support for the APR, and compared the model over the four survey years. Type of deer pursued and agency trust were the strongest predictors of APR support, followed by satisfaction with deer seen, and years of hunting experience. Hunters who targeted big bucks, had more trust in the agency, and expressed more satisfaction with deer seen in the field, were more supportive of the APR. Hunters who had more deer-hunting experience were less supportive.

  1. [Physical performance of older adults living in rural areas at sea level and at high altitude in Peru].

    PubMed

    Estela-Ayamamani, David; Espinoza-Figueroa, Jossué; Columbus-Morales, Mauricio; Runzer-Colmenares, Fernando; Parodi, José F; Mayta-Tristán, Percy

    2015-01-01

    Living at high altitudes requires the inhabitants to adapt biologically and socially to the environment. The objective of this study was to determine the difference in physical performance (PP) in rural populations at sea level and at high altitude. A cross-sectional study was conducted in rural communities in Ancash, Peru, located at 3.345 meters above sea level (m.a.s.l.) and also in communities located in coastal areas at 6m.a.s.l. PP was measured by the Short Physical Performance Battery (SPPB) and other associated factors. Adjusted prevalence ratios (aPR) were calculated. A total of 130 older adults were assessed in the high altitude communities and 129 on the coast. The median age was 71.4 years, and 55.6% were female. Low physical performance (SPPB ≤ 6) was 10.0% at high altitude and 19.4% on the coast (p<0.05). Factors associated with low physical performance were residing at the coast (aPR: 2.10, 95% CI 1.02 to 4.33), self-reported poor health (aPR: 2.48, 95% CI 1.21 -5.08), hypertension (aPR: 1.73, 95% CI 1.01 to 2.98), and age (aPR: 1.04, 95% CI 1.01 to 1.07), while being a farmer (aPR: 0.49, 95% CI 0.25 to 0.97), and being independent (aPR: 0.37, 95% CI 0,20-, 072) were found to be protective factors. It was also found that the inhabitants of the coast have a mean of 0.86 points lower total SPPB than the high altitude ones (p=0.004). There is an association between altitude of residence and PP in older adults. The prevalence of a low PP in older adults in rural areas at sea level is twice as high compared to those living in high altitude rural communities. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  2. Factors associated with consistent condom use and STIs among foreign female entertainment workers: results from a cross-sectional survey in Singapore.

    PubMed

    Lim, Raymond Boon Tar; Wong, Mee Lian; Cheung, Olive N Y; Tham, Dede Kam Tyng; Tai, Bee Choo; Chan, Roy

    2017-03-01

    We assessed the prevalence of consistent condom use and laboratory-confirmed STIs among foreign female entertainment workers (FEWs) who engaged in paid or casual sex in Singapore and the factors associated with these characteristics. A cross-sectional survey, using time-location sampling, was conducted on 220 FEWs (115 Vietnamese and 105 Thai) in 2015. For multivariable analysis, we used a mixed-effects Poisson regression model with backward stepwise approach to account for clustering by venue and to obtain the adjusted prevalence ratios (aPRs) of factors associated with consistent condom use and STI positivity, respectively. Consistent condom use with paid or casual partners in the past month was 39.6% and 36.2% for vaginal and oral sex, respectively. The prevalence of STI (cervical chlamydia, cervical gonorrhoea or pharyngeal gonorrhoea) positivity was 13.6%. In multivariable analysis, consistent condom use for both vaginal and oral sex increased with high self-perceived risk of getting STI/HIV (vaginal: aPR 2.09; 95% CI 1.26 to 3.46; oral: aPR 2.41; 95% CI 1.23 to 4.69) and condom negotiation (vaginal: aPR 3.74; 95% CI 2.07 to 6.75; oral: aPR 2.81; 95% CI 1.51 to 5.26). STI positivity decreased with consistent condom use for vaginal sex (aPR 0.22; 95% CI 0.07 to 0.75) and increased with number of sexual partners (aPR 1.43; 95% CI 1.07 to 1.92). In addition to advocating for policy decisions to provide a safer work environment, behavioural interventions on condom negotiation skills and condom use and biomedical interventions on STI/HIV testing and treatment interventions are needed among the FEWs in Singapore. NCT02780986; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Predictors of Exclusive Breastfeeding at Least 8 Weeks Among Asian and Native Hawaiian or Other Pacific Islander Race Subgroups in Hawaii, 2004–2008

    PubMed Central

    Mitchell, Kristen M.; Donohoe-Mather, Carolyn; Zaha, Rebecca L.; Melcher, Carol; Fuddy, Loretta J.

    2015-01-01

    Breastfeeding is nurturing, cost-effective, and beneficial for the health of mother and child. Babies receiving formula are sick more often and are at higher risk for childhood obesity, diabetes, asthma, and other conditions compared with breastfed children. National and international organizations recommend exclusive breastfeeding for 6 months. Exclusive breastfeeding in Asian and Native Hawaiian or Other Pacific Islander (NHOPI) subgroups is not well characterized. Data from the 2004–2008 Hawaii Pregnancy Risk Assessment Monitoring System, a population-based surveillance system on maternal behaviors and experiences before, during, and after pregnancy, were analyzed for 8,508 mothers with a recent live birth. We examined exclusive breastfeeding status for at least 8 weeks. We calculated prevalence risk ratios across maternal race groups accounting for maternal and sociodemographic characteristics. The overall estimate of exclusive breastfeeding for at least 8 weeks was 36.3 %. After adjusting for maternal age, pre-pregnancy weight, cesarean delivery, return to work/school, and self-reported postpartum depressive symptoms, the racial differences in prevalence ratios for exclusive breastfeeding for each ethnic group compared to Whites were: Samoan (aPR = 0.54; 95 % CI 0.43–0.69), Filipino (aPR = 0.58; 95 % CI 0.53–0.63), Japanese (aPR = 0.58; 95 % CI 0.52–0.65), Chinese (aPR = 0.64; 95 % CI 0.58–0.70), Native Hawaiian (aPR = 0.67; 95 % CI 0.61–0.72), Korean (aPR = 0.72; 95 % CI 0.64–0.82), and Black (aPR = 0.79; 95 % CI 0.65–0.96) compared to white mothers. Providers and community groups should be aware that just over one-third of mothers breastfeed exclusively at least 8 weeks with lower rates among Asian, NHOPI, and Black mothers. Culturally appropriate efforts to promote exclusive breastfeeding are recommended particularly among Asian subgroups that have high breastfeeding initiation rates that do not translate into high exclusivity rates. PMID

  4. Factors associated to inpatient mortality rates in type-2-diabetic patients: a cross-sectional analytical study in three Peruvian hospitals.

    PubMed

    Atamari-Anahui, Noé; Martinez-Ninanqui, Franklin W; Paucar-Tito, Liz; Morales-Concha, Luz; Miranda-Chirau, Alejandra; Gamarra-Contreras, Marco Antonio; Zea-Nuñez, Carlos Antonio; Mejia, Christian R

    2017-12-05

    Diabetes mortality has increased in recent years. In Peru, there are few studies on in-hospital mortality due to type 2 diabetes in the provinces. To determine factors associated to hospital mortality in patients with diabetes mellitus type 2 in three hospitals from Cusco-Peru. An analytical cross-sectional study was performed. All patients with diabetes mellitus type 2 hospitalized in the city of Cusco during the 2016 were included. Socio-educational and clinical characteristics were evaluated, with "death" as the variable of interest. The crude (cPR) and adjusted (aPR) prevalence ratios were estimated using generalized linear models with Poisson family and log link function, with their respective 95% confidence intervals (95% CI). The values p <0.05 were considered significant. A total of 153 patients were studied; 33.3% (51) died in the hospital. The mortality rate increased when the following factors were associated: age of the patients increased the mortality rate by one-year increments (aPR: 1.02; CI95%: 1.01-1.03; p<0.001); to have been admitted by the emergency service (aPR: 1.93; CI95%: 1.34-2.77; p<0.001); being a patient who is readmitted to the hospital (aPR: 2.01; CI95%: 1.36-2.98; p<0.001); and patients who have had a metabolic in-hospital complication (aPR: 1.61; CI95%: 1.07-2.43; p=0.024) or renal in-hospital complications (aPR: 1.47; CI95%: 1.30-1.67; p<0.001). Conversely, the mortality rate was reduced when admission was due to a urinary tract infection (aPR: 0.50; CI95%: 0.35-0.72; p<0.001); adjusted by seven variables. A third of hospitalized diabetes mellitus type 2 patients died during the study period. Mortality was increased as age rises, patients admitted through emergency rooms, patients who were readmitted to the hospital, and patients who had metabolic or renal complications. Patients admitted for a urinary tract infection had a lower mortality rate.

  5. Rapid Phenotyping Adult Plant Resistance to Stem Rust in Wheat Grown under Controlled Conditions.

    PubMed

    Riaz, Adnan; T Hickey, Lee

    2017-01-01

    Stem rust (SR) or black rust caused by Puccinia graminis f. sp. tritici is one of the most common diseases of wheat (Triticum aestivum L.) crops globally. Among the various control measures, the most efficient and sustainable approach is the deployment of genetically resistant cultivars. Traditionally, wheat breeding programs deployed genetic resistance in cultivars, but unknowingly this is often underpinned by a single seedling resistance gene, which is readily overcome by the pathogen. Nowadays, adult plant resistance (APR) is a widely adopted form of rust resistance because more durable mechanisms often underpin it. However, only a handful of SR APR genes are available, so breeders currently strive to combine seedling and APR genes. Phenotyping adult wheat plants for resistance to SR typically involves evaluation in the field. But establishing a rust nursery can be challenging, and screening is limited to once a year. This slows down research efforts to isolate new APR genes and breeding of genetically resistant cultivars.In this study, we report a protocol for rapid evaluation of adult wheat plants for resistance to stem rust. We demonstrate the technique by evaluating a panel of 16 wheat genotypes consisting of near isogenic lines (NILs) for known Sr genes (i.e., Sr2, Sr33, Sr45, Sr50, Sr55, Sr57, and Sr58) and three landraces carrying uncharacterized APR from the N. I. Vavilov Institute of Plant Genetic Resources (VIR). The method can be completed in just 10 weeks and involves two inoculations: first conducted at seedling stage and a second at the adult stage (using the same plants). The technique can detect APR, such as that conferred by APR gene Sr2, along with pseudo-black chaff (the morphological marker). Phenotyping can be conducted throughout the year, and is fast and resource efficient. Further, the phenotyping method can be applied to screen breeding populations or germplasm accessions using local or exotic races of SR.

  6. Lymph node retrieval in abdominoperineal surgical specimen is radiation time-dependent

    PubMed Central

    Sermier, Alain; Gervaz, Pascal; Egger, Jean F; Dao, My; Allal, Abdelkarim S; Bonet, Marta; Morel, Philippe

    2006-01-01

    Background A low yield of lymph nodes (LN) in abdominoperineal resection (APR) specimen has been associated with preoperative radiation therapy (XRT) in population-based studies, which may preclude adequate staging of anorectal carcinomas. We hypothesized that the number of LN retrieved in APR specimen was correlated with the dose and the timing of pelvic irradiation. Patients and methods We performed a retrospective study of 102 patients who underwent APR in a single institution between 1980 and 2004. Pathological reports were reviewed and the number of lymph nodes retrieved in APR specimens was correlated with: 1) Preoperative radiation; 2) Dose of pelvic irradiation; and 3) Time interval between the end of XRT and surgery. Results There were 61 men and 41 women, with a median age of 66 (range 25–89) years. There were 12 patients operated for squamous cell carcinoma of the anal canal (SCCA) and 90 for rectal cancer. 83% and 46% of patients with anal and rectal cancer respectively underwent radical/neoadjuvant radiotherapy. The mean ± SD number of LN in APR specimen was 9.2 ± 5.9. The mean number of LN in APR specimen was significantly lower in patients who underwent preoperative XRT (8 ± 5.5 vs. 10.5 ± 6.1, Mann-Whitney U test, p = 0.02). The mean number of LN was not significantly different after XRT in patients with SCCA than in patients with rectal cancer (6.2 ± 5.3 vs. 7.8 ± 5.3, p = 0.33). Finally, there was an inverse correlation between the yield of LN and the time elapsed between XRT and surgery (linear regression coefficient r = -0.32, p = 0.03). Conclusion Our data indicate that: 1) radiation therapy affects the yield of LN retrieval in APR specimen; 2) this impact is time-dependent. These findings have important implications with regard to anatomic-pathological staging of anal and rectal cancers and subsequent decision-making regarding adjuvant chemotherapy. PMID:16749931

  7. Efficacy of ProPhyt mixed with a low rate of Captec for control of peach scab in South Carolina, 2014

    USDA-ARS?s Scientific Manuscript database

    Fungicides were evaluated for control of scab in a mid-ripening experimental nectarine block (‘Redgold’) located at the Clemson University Research Station in Seneca, SC. Chemical formulations were applied with a handgun sprayer (200 gal/A spray volume) on 1 Apr (petal fall), 9 Apr (shuck split) and...

  8. JPRS Report, Science & Technology China: Energy

    DTIC Science & Technology

    1992-06-24

    HYDROPOWER Speeding Up Hydropower Construction Through Improved Investment Conditions [Yang Zhirong, Qu Shiyuan , et ai; ZHONGGUO NENGYUAN, 25 Apr 92] 2...Beijing ZHONGGUO NENGYUAN [ENERGY OF CHINA] in Chinese No 4, 25 Apr 92 pp 4-7 [Article by Yang Zhirong [2799 1807 2837], Qu Shiyuan [3255 2514

  9. Efficacy of fungicides for control of scab on a mid-ripening peach variety in middle Georgia, 2012

    USDA-ARS?s Scientific Manuscript database

    Fungicides were evaluated for control of scab in a mid-ripening experimental peach block (‘Flameprince’) located at the USDA-ARS Fruit and Tree Nut Research Laboratory (Byron, GA). Chemical formulations were applied at each application date: 3 Apr (petal fall to 1% shuck split), 10 Apr (shuck split ...

  10. Efficacy of petal fall and shuck split fungicides for control of scab on peach in middle Georgia, 2012

    USDA-ARS?s Scientific Manuscript database

    Fungicides were evaluated for control of scab in a mid-ripening experimental peach block (‘Flameprince’) located at the USDA-ARS Fruit and Tree Nut Research Laboratory (Byron, GA). Chemical formulations were applied at each application date: 3 Apr (petal fall to 1% shuck split), 10 Apr (shuck split ...

  11. A Longitudinal Study of Academic Progress Rate as a Result of Team and Institutional Variables at NCAA Division I Schools

    ERIC Educational Resources Information Center

    Hale, Jimmie Edwin

    2014-01-01

    This study explained Academic Progress Rate (APR) levels and differences in APR (DAPR) with team and institutional variables. Team variables included team gender, sport profile, and squad size. Institutional variables included individual variables aggregated to the institutional level. The data analyzed in this study was derived from the National…

  12. Ada (Tradename) Compiler Validation Summary Report. Harris Corporation. HARRIS Ada Compiler, Version 1.0. Harris H1200 and H800.

    DTIC Science & Technology

    This Validations Summary Report (VSR) summarizes the results and conclusions of validation testing performed on the HARRIS Ada Compiler, Version 1.0...at compile time, at link time, or during execution. On-site testing was performed 28 APR 1986 through 30 APR 1986 at Harris Corporation, Ft. Lauderdale

  13. Overlap Areas of a Square Box on a Square Mesh

    DTIC Science & Technology

    2017-04-01

    ARL-TN-0818 ● APR 2017 US Army Research Laboratory Overlap Areas of a Square Box on a Square Mesh by James U Cazamias...originator. ARL-TN-0818 ● APR 2017 US Army Research Laboratory Overlap Areas of a Square Box on a Square Mesh by James U Cazamias...

  14. Genetics Home Reference: carbonic anhydrase VA deficiency

    MedlinePlus

    ... implicates both enzymes in ammonia detoxification and glucose metabolism. Proc Natl Acad Sci U S A. 2013 Apr 30;110(18):7423-8. doi: 10.1073/pnas.1305805110. Epub 2013 Apr 15. Citation on PubMed or Free article on PubMed Central Sly WS, Hu PY. Human ...

  15. 76 FR 77728 - Process for a Designated Contract Market or Swap Execution Facility To Make a Swap Available To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ..., 2011 at 9; Letter from Robert Pickel and Kenneth Bentsen, International Swaps and Derivatives..., dated Apr. 5, 2011 at 19; Letter from Robert Pickel and Kenneth Bentsen, International Swaps and... LLP, on behalf of certain dealers, dated Apr. 5, 2011 at 19; Letter from Robert Pickel and Kenneth...

  16. Implication of the ERK/MAPK pathway in antipsychotics-induced dopamine D2 receptor upregulation and in the preventive effects of (±)-α-lipoic acid in SH-SY5Y neuroblastoma cells.

    PubMed

    Deslauriers, Jessica; Desmarais, Christian; Sarret, Philippe; Grignon, Sylvain

    2014-03-01

    Chronic administration of antipsychotics (APs) has been associated with dopamine D2 receptor (D2R) upregulation and tardive dyskinesia. We previously showed that haloperidol, a first-generation AP, exerted a more robust increase in D2R expression than amisulpride, a second-generation AP and that (±)-α-lipoic acid pre-treatment reversed the AP-induced D2R upregulation. We also demonstrated that the Akt/GSK-3β/β-catenin pathway is involved in the control of D2R expression levels, but is unlikely implicated in the preventive effects of (±)-α-lipoic acid since co-treatment with haloperidol and (±)-α-lipoic acid exerts synergistic effects on Akt/GSK-3β activation. These findings led us to examine whether the ERK/MAPK signaling pathway may be involved in D2R upregulation elicited by APs, and in its reversal by (±)-α-lipoic acid, in SH-SY5Y human neuroblastoma cells. Our results revealed that haloperidol, in parallel with an elevation in D2R mRNA levels, induced a larger increase of ERK (p42/p44) phosphorylation than amisulpride. Pre-treatment with the selective ERK inhibitor U0126 attenuated haloperidol-induced increase in D2R upregulation. Furthermore, (±)-α-lipoic acid prevented AP-induced ERK activation. These results show that (1) the ERK/MAPK pathway is involved in haloperidol-induced D2R upregulation; (2) the preventive effect of (±)-α-lipoic acid on haloperidol-induced D2R upregulation is in part mediated by an ERK/MAPK-dependent signaling cascade. Taken together, our data suggest that (±)-α-lipoic acid exerts synergistic effects with haloperidol on the Akt/GSK-3β pathway, potentially involved in the therapeutic effects of APs, and antagonism of ERK activation and D2R upregulation, potentially involved in tardive dyskinesia and treatment resistance.

  17. Differences in Dihydrotetrabenazine Isomer Concentrations Following Administration of Tetrabenazine and Valbenazine.

    PubMed

    Skor, Heather; Smith, Evan B; Loewen, Gordon; O'Brien, Christopher F; Grigoriadis, Dimitri E; Bozigian, Haig

    2017-09-01

    Tetrabenazine (TBZ) activity is thought to result from four isomeric dihydrotetrabenazine (HTBZ) metabolites ([+]-α-HTBZ, [-]-α-HTBZ, [+]-β-HTBZ, [-]-β-HTBZ). Each isomer has a unique profile of vesicular monoamine transporter 2 (VMAT2) inhibition and off-target binding. Previously published data only report total isomer (α) and (β) concentrations. We developed a method to quantify the individual HTBZ isomers in samples from patients with Huntington's disease receiving TBZ. For comparison, concentrations of [+]-α-HTBZ, the single active metabolite shared by valbenazine (VBZ) and TBZ, were determined in samples from patients with tardive dyskinesia receiving VBZ. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for quantitation of the four individual HTBZ isomers. Concentrations were determined in serum from patients with Huntington's disease administered TBZ and plasma from patients with tardive dyskinesia administered VBZ once daily. In patients administered TBZ, [-]-α-HTBZ and [+]-β-HTBZ were the most abundant HTBZ isomers while [-]-β-HTBZ and [+]-α-HTBZ were present as minor metabolites. Only [+]-α-HTBZ was observed in patients administered VBZ. Based on relative abundance and potency, [+]-β-HTBZ appears to be the primary contributor to VMAT2 inhibition by TBZ, a finding in contrast with the generally held assertion that [+]-α-HTBZ is the major contributor. [-]-α-HTBZ, the other abundant TBZ metabolite, has much lower VMAT2 inhibitory potency than [+]-β-HTBZ, but increased affinity for other CNS targets, which may contribute to off-target effects of TBZ. In contrast, pharmacological activity for VBZ is derived primarily from [+]-α-HTBZ. Individual HTBZ isomer concentrations provide a more clinically relevant endpoint for assessing on- and off-target effects of TBZ than total isomer concentrations.

  18. Social Stress and Substance Use Disparities by Sexual Orientation Among High School Students.

    PubMed

    Lowry, Richard; Johns, Michelle M; Robin, Leah E; Kann, Laura K

    2017-10-01

    Sexual minority youth often experience increased social stress due to prejudice, discrimination, harassment, and victimization. Increased stress may help explain the disproportionate use of substances like tobacco, alcohol, marijuana, and other illicit drug use by sexual minority youth. This study examined the effect of social stress on substance use disparities by sexual orientation among U.S. high school students. In 2016, data from the national 2015 Youth Risk Behavior Survey, conducted among a nationally representative sample of 15,624 U.S. high school students, were analyzed to examine the effect of school-related (threatened/injured at school, bullied at school, bullied electronically, felt unsafe at school) and non-school-related (forced sexual intercourse, early sexual debut) social stress on substance use disparities by sexual orientation, by comparing unadjusted prevalence ratios (PRs) and adjusted (for social stressors, age, sex, and race/ethnicity) prevalence ratios (APRs). Unadjusted PRs reflected significantly (p<0.05 or 95% CI did not include 1.0) greater substance use among students who identified as lesbian/gay or bisexual than students who identified as heterosexual. APRs for injection drug use decreased substantially among lesbian/gay (PR=12.02 vs APR=2.14) and bisexual (PR=2.62 vs APR=1.18) students; the APR for bisexual students became nonsignificant. In addition, APRs among both lesbian/gay and bisexual students decreased substantially and were no longer statistically significant for cocaine, methamphetamine, and heroin use. School-based substance use prevention programs might appropriately include strategies to reduce social stress, including policies and practices designed to provide a safe school environment and improved access to social and mental health services. Published by Elsevier Inc.

  19. Carotenoids buffer the acute phase response on fever, sickness behavior and rapid bill color change in zebra finches.

    PubMed

    George, Deanna B; Schneider, Brent C; McGraw, Kevin J; Ardia, Daniel R

    2017-08-15

    Carotenoids are finite resources that animals can allocate to self-maintenance, attractiveness or reproduction. Here we test how carotenoids affect the acute phase response (APR), an intense rapid systemic response characterized by fever, sickness behavior and production of acute phase proteins, which serves to reduce pathogen persistence. We conducted a 2×2 factorial design experiment in captive adult male and female zebra finches ( Taeniopygia guttata ) to determine the effects of carotenoid supplementation on the intensity of the APR. We measured changes in feeding rate, activity level and body temperature of the birds. We found that, relative to unsupplemented controls, carotenoid-supplemented birds exhibited less severe reductions in feeding and activity, smaller increases in body temperature and lower circulating levels of haptoglobin (an acute phase protein) 24 h after inducing an APR. Among supplemented individuals, those with higher blood carotenoid levels exhibited a lower reduction in activity rate after 24 h. Forty-eight hours after APR induction, birds exhibited a significant decrease in plasma carotenoid levels and a decrease in bill hue, with less reduction in hue in carotenoid-supplemented individuals. These results demonstrate that carotenoids can alleviate several important behavioral and physiological effects of an APR and that bill color can change rapidly following induction of the costly APR immune defense. In particular, immune activation may have caused birds to preferentially draw down carotenoids from the bloodstream, ostensibly for use in health. Rapid bill color changes over a 48-h period support growing evidence that bills may serve as short-term signals of health and condition. © 2017. Published by The Company of Biologists Ltd.

  20. Characteristics and Risk Behaviors of Men Who Have Sex With Men and Women Compared With Men Who Have Sex With Men-20 US Cities, 2011 and 2014.

    PubMed

    Shadaker, Shaun; Magee, Matthew; Paz-Bailey, Gabriela; Hoots, Brooke E

    2017-07-01

    Men who have sex with men (MSM) are heterogeneous with respect to sexual behavior. We examined differences in sex behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO). Data for this analysis were from MSM who participated in National HIV Behavioral Surveillance in 2011 and 2014. We used the combined years to evaluate demographic and behavioral differences between MSMW and MSMO. Using log-linked Poisson regression models, adjusted prevalence ratios (aPR) were calculated for behavioral outcomes. Overall, 2042 (11.9%) participants were classified as MSMW. MSMW were less likely than MSMO to have condomless sex with male partners [aPR 0.77; 95% confidence interval (CI): 0.74 to 0.81] and to have been diagnosed with another sexually transmitted disease (aPR 0.83; 95% CI: 0.72 to 0.95). MSMW were more likely than MSMO to have given money or drugs for sex (aPR 2.85; 95% CI: 2.52 to 3.24) or received money or drugs for sex (aPR 2.64; 95% CI: 2.37 to 2.93) and to ever have injected drugs (aPR 2.05; 95% CI: 1.80 to 2.34). MSMW had more total sex partners (median 6, interquartile range: 4-11 vs. 3, 2-8), casual sex partners (5, 2-10 vs. 3, 1-7), and condomless sex partners (2, 1-4 vs. 1, 0-2) in the last 12 months (P < 0.01 for all comparisons). MSMW have distinct sexual risk behaviors from MSMO and may contribute to HIV transmission among women. MSMW could benefit from tailored interventions to reduce HIV risk behaviors.

  1. Evaluation of nutritional and economic feed values of spent coffee grounds and Artemisia princeps residues as a ruminant feed using in vitro ruminal fermentation

    PubMed Central

    Seo, Jakyeom; Jung, Jae Keun

    2015-01-01

    Much research on animal feed has focused on finding alternative feed ingredients that can replace conventional ones (e.g., grains and beans) to reduce feed costs. The objective of this study was to evaluate the economic, as well as nutritional value of spent coffee grounds (SCG) and Japanese mugwort (Artemisia princeps) residues (APR) as alternative feed ingredients for ruminants. We also investigated whether pre-fermentation using Lactobacillus spp. was a feasible way to increase the feed value of these by-products. Chemical analyses and an in vitro study were conducted for SCG, APR, and their pre-fermented forms. All the experimental diets for in vitro ruminal fermentation were formulated to contain a similar composition of crude protein, neutral detergent fiber and total digestible nutrients at 1x maintenance feed intake based on the dairy National Research Council (NRC). The control diet was composed of ryegrass, corn, soybean meal, whereas the treatments consisted of SCG, SCG fermented with Lactobacillus spp. (FSCG), APR, and its fermented form (FAPR). The treatment diets replaced 100 g/kg dry matter (DM) of the feed ingredients in the control. Costs were lower for the all treatments, except FAPR, than that of the control. After 24-h incubation, the NDF digestibility of the diets containing SCG and its fermented form were significantly lower than those of the other diets (P < 0.01); pre-fermentation tended to increase NDF digestibility (P = 0.07), especially for APR. Supplementation of SCG significantly decreased total gas production (ml/g DM) after 24-h fermentation in comparison with the control (P < 0.05); however, there were no significant differences between the control and the SCG or the APR diets in total gas production, as expressed per Korean Won (KRW). Diets supplemented with SCG or FSCG tended to have a higher total volatile fatty acid (VFA) concentration, expressed as per KRW, compared with the control (P = 0.06). Conversely, the fermentation

  2. Evaluation of nutritional and economic feed values of spent coffee grounds and Artemisia princeps residues as a ruminant feed using in vitro ruminal fermentation.

    PubMed

    Seo, Jakyeom; Jung, Jae Keun; Seo, Seongwon

    2015-01-01

    Much research on animal feed has focused on finding alternative feed ingredients that can replace conventional ones (e.g., grains and beans) to reduce feed costs. The objective of this study was to evaluate the economic, as well as nutritional value of spent coffee grounds (SCG) and Japanese mugwort (Artemisia princeps) residues (APR) as alternative feed ingredients for ruminants. We also investigated whether pre-fermentation using Lactobacillus spp. was a feasible way to increase the feed value of these by-products. Chemical analyses and an in vitro study were conducted for SCG, APR, and their pre-fermented forms. All the experimental diets for in vitro ruminal fermentation were formulated to contain a similar composition of crude protein, neutral detergent fiber and total digestible nutrients at 1x maintenance feed intake based on the dairy National Research Council (NRC). The control diet was composed of ryegrass, corn, soybean meal, whereas the treatments consisted of SCG, SCG fermented with Lactobacillus spp. (FSCG), APR, and its fermented form (FAPR). The treatment diets replaced 100 g/kg dry matter (DM) of the feed ingredients in the control. Costs were lower for the all treatments, except FAPR, than that of the control. After 24-h incubation, the NDF digestibility of the diets containing SCG and its fermented form were significantly lower than those of the other diets (P < 0.01); pre-fermentation tended to increase NDF digestibility (P = 0.07), especially for APR. Supplementation of SCG significantly decreased total gas production (ml/g DM) after 24-h fermentation in comparison with the control (P < 0.05); however, there were no significant differences between the control and the SCG or the APR diets in total gas production, as expressed per Korean Won (KRW). Diets supplemented with SCG or FSCG tended to have a higher total volatile fatty acid (VFA) concentration, expressed as per KRW, compared with the control (P = 0.06). Conversely, the fermentation

  3. 7 CFR 29.1031 - Lemon (L).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Lemon (L). 29.1031 Section 29.1031 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1031 Lemon (L). Yellow. [42 FR 21092, Apr. 25, 1977. Redesignated at 49 FR 16755, Apr. 20...

  4. 7 CFR 29.1031 - Lemon (L).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Lemon (L). 29.1031 Section 29.1031 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1031 Lemon (L). Yellow. [42 FR 21092, Apr. 25, 1977. Redesignated at 49 FR 16755, Apr. 20...

  5. 7 CFR 29.1031 - Lemon (L).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Lemon (L). 29.1031 Section 29.1031 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1031 Lemon (L). Yellow. [42 FR 21092, Apr. 25, 1977. Redesignated at 49 FR 16755, Apr. 20...

  6. A Call To Action III: 1989/90 Legislative Agenda.

    ERIC Educational Resources Information Center

    Association of Puerto Rican Executive Directors, New York, NY.

    This publication of the Association of Puerto Rican Executive Directors (APRED) presents recommendations for action by the New York State legislature to improve opportunities and services for the Puerto Rican and Latino community. The agenda for legislative action, produced by the APRED Legislative Task Force, calls for the integration of the…

  7. 7 CFR 29.1031 - Lemon (L).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Lemon (L). 29.1031 Section 29.1031 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1031 Lemon (L). Yellow. [42 FR 21092, Apr. 25, 1977. Redesignated at 49 FR 16755, Apr. 20...

  8. 7 CFR 29.1031 - Lemon (L).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Lemon (L). 29.1031 Section 29.1031 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1031 Lemon (L). Yellow. [42 FR 21092, Apr. 25, 1977. Redesignated at 49 FR 16755, Apr. 20...

  9. Advanced Undersea Warfare Systems

    DTIC Science & Technology

    2011-06-01

    122 hours188 187 Rowinski, Lech . “Submersible propulsion and energy.” 18 Mar. 2002. underwater.pg.gda.pl. 23 Apr. 2011. <http...Rowinski, Lech . “Submersible propulsion and energy.” 18 Mar. 2002. underwater.pg.gda.pl. 23 Apr. 2011. <http://www.underwater.pg.gda.pl/publikacje

  10. United States Air Force (USAF) Semantic Interoperability Capabilities Based Assessment and Technology Roadmap

    DTIC Science & Technology

    2007-03-01

    features Federated Search (providing services to find and aggregate information across GIG enterprise data sources); Enterprise Catalog (providing...Content Discovery Federated Search Portlet Users Guide v0.4.3 M16 25-Apr-05 NCES Mediation Core Enterprise Services SDK v0.5.0 M17 25-Apr-05 NCES

  11. 2018 New Drug Update.

    PubMed

    Hussar, Daniel A; Finn, Laura A

    2018-04-01

    Five new drugs marketed within the last year, which are used for medical problems often experienced by the elderly, have been selected for consideration in this review. The uses and most important properties of these agents are discussed, and a rating for each new drug is determined using the New Drug Comparison Rating system developed by the author (DAH). Advantages, disadvantages, and other important information regarding each new drug are identified and used as the basis for determining the rating. The drugs include an anticoagulant, an antiparkinson agent, an agent for tardive dyskinesia, an agent for psoriasis, and an agent for constipation. The drugs reviewed are betrixaban, safinamide mesylate, valbenazine tosylate, guselkumab, and plecanatide.

  12. Deep brain stimulation as a functional scalpel.

    PubMed

    Broggi, G; Franzini, A; Tringali, G; Ferroli, P; Marras, C; Romito, L; Maccagnano, E

    2006-01-01

    Since 1995, at the Istituto Nazionale Neurologico "Carlo Besta" in Milan (INNCB,) 401 deep brain electrodes were implanted to treat several drug-resistant neurological syndromes (Fig. 1). More than 200 patients are still available for follow-up and therapeutical considerations. In this paper our experience is reviewed and pioneered fields are highlighted. The reported series of patients extends the use of deep brain stimulation beyond the field of Parkinson's disease to new fields such as cluster headache, disruptive behaviour, SUNCt, epilepsy and tardive dystonia. The low complication rate, the reversibility of the procedure and the available image guided surgery tools will further increase the therapeutic applications of DBS. New therapeutical applications are expected for this functional scalpel.

  13. Effect of excessive acute-phase response on liver regeneration after partial hepatectomy in rats.

    PubMed

    Kusashio, Kimihiko; Shimizu, Hiroaki; Kimura, Fumio; Yoshidome, Hiroyuki; Ohtsuka, Masayuki; Kato, Atsushi; Yoshitomi, Hideyuki; Furukawa, Katsunori; Fukada, Tadaomi; Miyazaki, Masaru

    2009-01-01

    Acute-phase response (APR) is known to have a protective role against infection and tissue injury including partial hepatectomy (HTX). In this study, the effect of excessive APR on liver regeneration was investigated using a rat hepatectomized model. Experimental APR was induced by subcutaneous injection of turpentine oil, immediately, 24 h and 48 h after 50% HTX. Serum IL-6 and hepatic alpha2-macroglobulin mRNA was evaluated in rats receiving turpentine or saline as control after HTX. DNA synthesis and PCNA labeling index in the remnant liver was also investigated. Furthermore, in vitro total hepatic protein synthesis (TPS) and secretory protein synthesis (SPS) in the remnant liver were measured. Liver regeneration was significantly inhibited after HTX in the turpentine group, compared to the control. DNA synthesis and PCNA labeling index was also significantly decreased on days 1 and 2. A remarkable increase in the serum IL-6 and hepatic alpha2-macroglobulin mRNA was found in the turpentine group. Furthermore, SPS was significantly upregulated in the turpentine group, although TPS was almost similar between the groups. Induction of excessive APR after HTX inhibits liver regeneration. Acute phase protein synthesis is remarkably upregulated within the capacity of hepatic protein synthesis, most probably by a reduction in replicative protein synthesis, suggesting that APR may be more appropriate biological response for ensuring immediate survival.

  14. Effect of academic status on outcomes of surgery for rectal cancer.

    PubMed

    Cagino, Kristen; Altieri, Maria S; Yang, Jie; Nie, Lizhou; Talamini, Mark; Spaniolas, Konstantinos; Denoya, Paula; Pryor, Aurora

    2018-06-01

    The purpose of our study was to investigate surgical outcomes following advanced colorectal procedures at academic versus community institutions. The SPARCS database was used to identify patients undergoing Abdominoperineal resection (APR) and Low Anterior Resection between 2009 and 2014. Linear mixed models and generalized linear mixed models were used to compare outcomes. Laparoscopic versus open procedures, surgery type, volume status, and stoma formation between academic and community facilities were compared. Higher percentages of laparoscopic surgeries (58.68 vs. 41.32%, p value < 0.0001), more APR surgeries (64.60 vs. 35.40%, p value < 0.0001), more high volume hospitals (69.46 vs. 30.54%, p value < 0.0001), and less stoma formation (48.00 vs. 52.00%, p value < 0.0001) were associated with academic centers. After adjusting for confounding factors, academic facilities were more likely to perform APR surgeries (OR 1.35, 95% CI 1.04-1.74, p value = 0.0235). Minorities and Medicaid patients were more likely to receive care at an academic facility. Stoma formation, open surgery, and APR were associated with longer LOS and higher rate of ED visit and 30-day readmission. Laparoscopy and APR are more commonly performed at academic than community facilities. Age, sex, race, and socioeconomic status affect the facility at which and the type of surgery patients receive, thereby influencing surgical outcomes.

  15. Apolipoprotein A-II induces acute-phase response associated AA amyloidosis in mice through conformational changes of plasma lipoprotein structure.

    PubMed

    Yang, Mu; Liu, Yingye; Dai, Jian; Li, Lin; Ding, Xin; Xu, Zhe; Mori, Masayuki; Miyahara, Hiroki; Sawashita, Jinko; Higuchi, Keiichi

    2018-04-04

    During acute-phase response (APR), there is a dramatic increase in serum amyloid A (SAA) in plasma high density lipoproteins (HDL). Elevated SAA leads to reactive AA amyloidosis in animals and humans. Herein, we employed apolipoprotein A-II (ApoA-II) deficient (Apoa2 -/- ) and transgenic (Apoa2Tg) mice to investigate the potential roles of ApoA-II in lipoprotein particle formation and progression of AA amyloidosis during APR. AA amyloid deposition was suppressed in Apoa2 -/- mice compared with wild type (WT) mice. During APR, Apoa2 -/- mice exhibited significant suppression of serum SAA levels and hepatic Saa1 and Saa2 mRNA levels. Pathological investigation showed Apoa2 -/- mice had less tissue damage and less inflammatory cell infiltration during APR. Total lipoproteins were markedly decreased in Apoa2 -/- mice, while the ratio of HDL to low density lipoprotein (LDL) was also decreased. Both WT and Apoa2 -/- mice showed increases in LDL and very large HDL during APR. SAA was distributed more widely in lipoprotein particles ranging from chylomicrons to very small HDL in Apoa2 -/- mice. Our observations uncovered the critical roles of ApoA-II in inflammation, serum lipoprotein stability and AA amyloidosis morbidity, and prompt consideration of therapies for AA and other amyloidoses, whose precursor proteins are associated with circulating HDL particles.

  16. Combination of pseudocontinent perineal colostomy and appendicostomy: a new approach in the treatment of low rectal cancer.

    PubMed

    Azizi, Rasoul; Alvandipour, Mina; Shoar, Saeed; Mahjoubi, Bahar

    2013-10-01

    Abdominal perineal resection (APR) with applied colostomy remains the standard treatment for low rectal cancer; however, to date, a very high morbidity rate has been reported. The aims of this study were to assess fecal continence, persistence of disease-related symptoms, and quality of life in patients with low rectal cancer after APR and pseudocontinent perineal colostomy and concomitant appendicostomy. We included 17 patients with low rectal cancer who underwent APR at our hospital in this cross-sectional study. Following APR, pseudocontinent perineal colostomy and concomitant appendicostomy were performed. Patients then underwent antegrade colonic enema with tap water. Patients' symptoms, fecal continence, and quality of life were evaluated at regular time intervals. After a median follow-up of 12 months, 15 of 17 patients completed the study period. All patients were able to perform an antegrade enema by themselves. Mean continence score was 7 (out of 20) based on the Wexner Scale scoring system. Mean global health status score was 78, physical function was 93, and emotional function was 88. Minor morbidity was observed in 6 patients (40%). Pseudocontinent perineal colostomy with appendicostomy provides an acceptable level of continence and functional and emotional improvement in patients with low rectal cancer undergoing APR. Hence, this combinative method could be considered as an alternative for abdominal colostomy in selected patients.

  17. Social Support, Sexual Violence, and Transactional Sex Among Female Transnational Migrants to South Africa

    PubMed Central

    Giorgio, Margaret; Townsend, Loraine; Zembe, Yanga; Guttmacher, Sally; Kapadia, Farzana; Cheyip, Mireille; Mathews, Catherine

    2018-01-01

    Objectives To examine the relationship between sexual violence and transactional sex and assess the impact of social support on this relationship among female transnational migrants in Cape Town, South Africa. Methods In 2012 we administered a behavioral risk factor survey using respondent-driven sampling to transnational migrant women aged between 16 and 39 years, born outside South Africa, living in Cape Town, and speaking English, Shona, Swahili, Lingala, Kirundi, Kinyarwanda, French, or Somali. Results Controlling for study covariates, travel-phase sexual violence was positively associated with engagement in transactional sex (adjusted prevalence ratio [APR] = 1.38; 95% confidence interval [CI] = 1.07, 1.77), and social support was shown to be a protective factor (APR = 0.84; 95% CI = 0.75, 0.95). The interaction of experienced sexual violence during migration and social support score was APR = 0.85 (95% CI = 0.66, 1.10). In the stratified analysis, we found an increased risk of transactional sex among the low social support group (APR = 1.56; 95% CI = 1.22, 2.00). This relationship was not statistically significant among the moderate or high social support group (APR = 1.04; 95% CI = 0.58, 1.87). Conclusions Programs designed to strengthen social support may reduce transactional sex among migrant women after they have settled in their receiving communities. PMID:29417089

  18. Cancer développé sur dilatation kystique de la voie biliaire: à propos d’un cas

    PubMed Central

    Soufi, Mehdi; Lahlou, Mohammed Khalid; Chad, Bouziane

    2014-01-01

    Les auteurs rapportent un cas de dilatation kystique du cholédoque intra- pancréatique découvert chez une femme de 46 ans et compliqué d'un carcinome tubulo-papillaire n'envahissant pas le pancréas. Le traitement a consisté en une duodénopancréatectomie céphalique avec un curage ganglionnaire et anastomose hépatico-jéjunale; la survie était de 30 mois; les auteurs abordent les aspects radiologiques, anatomopathologiques, thérapeutiques et pronostiques de ces cancers développé sur dilatation kystique de la voie biliaire et discutent la place d'une radiothérapie complémentaire de la chirurgie susceptible d'améliorer la survie. PMID:25922635

  19. [Breast augmentation by implants: a review of surgical practices. A study among French plastic surgeons].

    PubMed

    Chekaroua, K; Delay, E

    2005-10-01

    In the framework of the 2005 report on mammary implants prepared by the Société française de chirurgie plastique reconstructrice et esthétique (SOF.CPRE), we conducted a survey among french plastic surgeons involved in the field. We elaborated a questionnaire that we distributed twice to the 600 members of the society; a total of 261 responded. Analysis of the data collected provides information on the socioprofessional characteristics of the responding surgeons, and on the devices, products and techniques they use. Finally, the survey has permitted to identify their qualitative perception of breast implant products currently available. Ranking these items by order of frequency provides a snapshot of the current procedures and practices in use for breast augmentation surgery in France.

  20. Tuberculose péritonéale pseudo tumorale mimant un cancer ovarien: un diagnostic différentiel important à considérer

    PubMed Central

    Moukit, Mounir; Fadel, Fatimazahra Ait El; Kouach, Jaouad; Babahabib, Abdellah; Dehayni, Mohammed; Rahali, Driss Moussaoui

    2016-01-01

    La tuberculose est une maladie infectieuse curable qui peut simuler dans sa localisation péritonéale un cancer ovarien avancé conduisant ainsi à une chirurgie étendue et inutile souvent chez des femmes en âge de reproduction. Nous rapportons un nouveau cas de tuberculose péritonéale pseudo tumorale chez une patiente âgée de 43 ans chez qui le diagnostic d’un cancer ovarien avec carcinose péritonéale avait été suspecté. La laparotomie exploratrice avec examen histologique extemporané ont permis de confirmer le diagnostic de tuberculose péritonéale. La patiente a bien répondu au traitement antituberculeux selon le protocole 2ERHZ/4RH. PMID:28292155

  1. Le syndrome d’Usher: à propos d’une observation

    PubMed Central

    Daoudi, Chama; boutimzine, Noureddine; Haouzi, Samia El; Lezrek, Omar; Tachfouti, Samira; Lezrek, Mounir; Laghmari, Mina; Daoudi, Rajae

    2017-01-01

    Résumé Le syndrome d'Usher est une maladie génétique comportant une double atteinte sensorielle (auditive et visuelle) appelée surdicécité. Nous rapportons l'observation d'un patient de 50 ans, issue d'un mariage consanguin présentant une surdité congénitale avec une fonction vestibulaire normale et une rétinopathie pigmentaire responsable d'une baisse bilatérale de l'acuité visuelle apparue vers l'âge de 16 ans. Cette association compose le type 2 du syndrome d'Usher, affection rare de transmission autosomique récessive. La chirurgie de la cataracte a permis une amélioration de l'acuité visuelle chez ce patient. PMID:28979619

  2. 40 CFR 52.1335 - Compliance schedules.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... June 20, 1979 July 20, 1979 Mar. 1, 1984. St. Joe Minerals Corp., Pea Ridge Iron Ore Facility... Ridge Iron Ore Facility ......do ......do Apr. 22, 1981 Dec. 28, 1981 July 1, 1985. Associated Electric... Immediately Oct. 27, 1984. AMAX Lead Co Boss, MO ......do ......do ......do Apr. 27, 1985. (b) The compliance...

  3. USSR Report, Life Sciences, Biomedical and Behavioral Sciences

    DTIC Science & Technology

    1987-02-10

    S. B. Akopov, S. N. Kuzmina , et al.; DOKLADY AKADEMII NAUK SSSR, No 3, Apr 86) 4 Amino Acid Thermal Polycondensation Model in Migratory...AKADEMII NAUK SSSR in Russian Vol 287, No 3, Apr 86 (manuscript received 19 Nov 85) pp 724-728 [Article by S. B. Akopov, S. N. Kuzmina , T. V

  4. Prospects for the Development and Internationalization of Higher Education in Asia

    ERIC Educational Resources Information Center

    Krechetnikov, Konstantin; Pestereva, Nina; Rajovic, Goran

    2016-01-01

    This study investigates the current process of internationalization of higher education in the countries of the Asia Pacific region (APR) through the example of China, the Republic of Korea, Japan, and Russia. The article aims to familiarize the reader with the experience of internationalizing higher education in APR states against a backdrop of…

  5. Integrated Personnel and Pay System-Army Increment 1 (IPPS-A Inc 1)

    DTIC Science & Technology

    2016-03-01

    Acquisition Executive DoD - Department of Defense DoDAF - DoD Architecture Framework FD - Full Deployment FDD - Full Deployment Decision FY...2013 Feb 2014 Increment I FDD Apr 2013 Apr 2014 Full Deployment1 Jan 2015 Jul 2015 Memo Per 10 U.S.C. Chapter 144A, the MS C Decision exceeded the

  6. Piracy and Maritime Terrorism; A Seamless Transition

    DTIC Science & Technology

    2004-05-18

    1/.html>. [24 April 2004]. Cropley , Ed. “Asia eyes sea security after threats, US warning.” Reuters. 22 Apr 2004. <http://www.marketnewzealand.com...stm>. ii Ed Cropley , “Asia eyes sea security after threats, US warning,” Reuters, 22 Apr 2004. <http://www.marketnewzealand.com/mnz/News/Story.aspx

  7. Lifestyle, socioeconomic characteristics, and medical history of elderly persons who receive seasonal influenza vaccination in a tax-supported healthcare system.

    PubMed

    Hellfritzsch, Maja; Thomsen, Reimar Wernich; Baggesen, Lisbeth Munksgård; Larsen, Finn Breinholt; Sørensen, Henrik Toft; Christiansen, Christian Fynbo

    2017-04-25

    Observational studies on effectiveness of influenza vaccination in the elderly are thought to be biased by healthier lifestyles and higher socioeconomic status among vaccinated vs. unvaccinated persons. We examined this hypothesis in a uniform tax-supported health care system with free-of-charge influenza vaccination to the elderly. We conducted a cross-sectional study among Danes aged 65-79years participating in a survey. We compared elderly persons with and without a recent (within six months) influenza vaccination in terms of (i) lifestyle and socioeconomic characteristics obtained from the survey and (ii) health factors including medical history provided by Danish registries. We compared the prevalence of study variables among vaccinated and unvaccinated persons using age- and sex-adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs). Among the 4237 elderly persons completing the survey, 1718 (41%) had received an influenza vaccination. Vaccinated persons had more comorbidity than unvaccinated persons (aPR for high comorbidity level: 1.51 95% CI 1.24-1.84), were less likely to never have smoked (aPR: 0.88, 95% CI 0.80-0.97), and had a higher prevalence of physical inactivity (aPR: 1.08, 95% CI 1.03-1.13). Levels of education and income were similar in the two groups. Vaccinated persons had a higher prevalence of major physical limitations (aPR: 1.40, 95% CI 1.17-1.66) and need for assistance with activities of daily living (aPR: 1.29, 95% CI 1.13-1.47). Elderly influenza vaccinated persons were not healthier in terms of lifestyle and burden of disease, did not have a higher socioeconomic status, and were more frail than unvaccinated persons. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Regulation of Spi 2.1 and 2.2 gene expression after turpentine inflammation: discordant responses to IL-6.

    PubMed

    Berry, S A; Bergad, P L; Stolz, A M; Towle, H C; Schwarzenberg, S J

    1999-06-01

    The rat serine protease inhibitor (Spi) 2 gene family includes both positive (Spi 2.2) and negative (Spi 2.1) acute phase reactants, facilitating modeling of regulation of hepatic acute phase response (APR). To examine the role of signal transducer and activation of transcription (STAT) proteins in the divergent regulation of these model genes after induction of APR, we evaluated the proximal promoters of the genes, focusing on STAT binding sites contained in these promoter elements. Induction of APR by turpentine injection includes activation of a STAT3 complex that can bind to a gamma-activated sequence (GAS) in the Spi 2.2 gene promoter, although the Spi 2.2 GAS site can bind STAT1 or STAT5 as well. To create an in vitro model of APR, primary hepatocytes were treated with combinations of cytokines and hormones to mimic the hormonal milieu of the whole animal after APR induction. Incubation of primary rat hepatocytes with interleukin (IL)-6, a critical APR cytokine, leads to activation of STAT3 and a 28-fold induction of a chloramphenicol acetyltransferase reporter construct containing the -319 to +85 region of the Spi 2.2 promoter. This suggests the turpentine-induced increase of Spi 2.2 is mediated primarily by IL-6. In contrast, although turpentine treatment reduces Spi 2.1 mRNA in vivo and IL-6 does not increase Spi 2.1 mRNA in primary rat hepatocytes, treatment of hepatocytes with IL-6 results in a 5. 4-fold induction of Spi 2.1 promoter activity mediated through the paired GAS elements in this promoter. Differential regulation of Spi 2.1 and 2.2 genes is due in part to differences in the promoters of these genes at the GAS sites. IL-6 alone fails to reproduce the pattern of rat Spi 2 gene expression that results from turpentine-induced inflammation.

  9. Association Between Consumption of Sugar-Sweetened Beverages and Sociodemographic Characteristics Among Mississippi Adults

    PubMed Central

    Vargas, Rodolfo; Payton, Marinelle; Cannon-Smith, Gerri

    2017-01-01

    Introduction The consumption of sugar-sweetened beverages (SSBs) is linked to excessive weight gain, diabetes, and risk of cardiovascular disease. We examined the association between SSB consumption and sociodemographic characteristics among Mississippi adults. Methods We used data from the 2012 Mississippi Behavioral Risk Factor Surveillance System, which collected information on SSB consumption from 7,485 respondents. We used logistic regression models to calculate adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) for characteristics associated with SSB consumption. Results In 2012, 40.8% of Mississippi adults reported consuming at least one SSB daily. The likelihood of consuming SSBs at least once daily among respondents aged 18 to 34 years was 2.81 times higher (APR, 2.81; 95% CI, 2.49–3.18) than among those aged 65 years or older. The prevalence among men was 20% higher (APR, 1.20; 95% CI, 1.11–1.30) than among women and 23% higher (APR, 1.23; 95% CI, 1.13–1.35) among black respondents than among white respondents. The prevalence among respondents with less than a high school education was 25% higher (APR, 1.25; 95% CI, 1.11–1.41) than among those who with more than a high school education and 33% higher (APR, 1.33; 95% CI, 1.16–1.52) among those with an annual household income of less than $20,000 than among those with an income of $50,000 or more. Conclusion Among Mississippi adults, age, sex, race, education level, and income are associated with an increased likelihood of SSB consumption. Findings highlight the need for policies and interventions to address SSB consumption and promote alternatives to SSBs among Mississippians. PMID:29267157

  10. Annual Percentage Rate and Annual Effective Rate: Resolving Confusion in Intermediate Accounting Textbooks

    ERIC Educational Resources Information Center

    Vicknair, David; Wright, Jeffrey

    2015-01-01

    Evidence of confusion in intermediate accounting textbooks regarding the annual percentage rate (APR) and annual effective rate (AER) is presented. The APR and AER are briefly discussed in the context of a note payable and correct formulas for computing each is provided. Representative examples of the types of confusion that we found is presented…

  11. Aspects épidémiologiques, diagnostiques et thérapeutiques des ostéosarcomes de l'enfant au CHU Aristide le Dantec de Dakar: à propos de 16 cas

    PubMed Central

    Ndour, Oumar; Alumeti, Desire Munyali; Fall, Mbaye; Fall, Aimée Faye; Diouf, Cheikh; Ndoye, Ndeye Aby; Ngom, Gabriel; Ndoye, Mamadou

    2013-01-01

    Le but de cette étude était de décrire les aspects épidémiologiques, diagnostiques et thérapeutiques des ostéosarcomes de l'enfant. Il s'agissait d'une étude rétrospective sur dix ans qui a colligé 16 dossiers d'ostéosarcome pris en charge au service de Chirurgie Pédiatrique de l'hôpital Aristide Le Dantec de Dakar. Les paramètres étudiés étaient le niveau d'instruction et le niveau socioprofessionnel des parents, l'origine géographique, l’âge, le sexe, les antécédents particuliers, le délai de consultation, les motifs de consultation, les signes physiques, les signes radiologiques, la biologie, les modalités thérapeutiques et l’évolution. Tous les patients avaient bénéficié d'un examen anatomopathologique qui a confirmé le diagnostic d'ostéosarcome. Pour la majeure partie de nos patients (58% des cas) les parents avaient un niveau d'instruction bas. L’âge moyen était de 11ans. Une prédominance masculine était retrouvée avec un sex-ratio de 3,25:1. Le délai de consultation moyen était de 16 mois. Le principal motif de consultation était la tuméfaction (10 cas). Huit patients avaient bénéficié d'un traitement traditionnel. La taille de la tumeur était supérieure à 10cm dans 14 cas. La localisation la plus fréquente était le genou (14 cas). La radiographie standard retrouvait dans 15 cas des images d'ostéolyse. Le bilan d'extension n'avait pas retrouvé de métastases. Les options thérapeutiques étaient dominées par l'amputation seule (43,75% des cas). La survie à 2 ans était de 17%. L'ostéosarcome atteint le plus souvent le garçon après l’âge de 10 ans. Sa prise en charge au Sénégal se heurte à d’énormes difficultés liées au retard diagnostique. La solution repose essentiellement sur une collaboration pluridisciplinaire. PMID:23720705

  12. Murine serum glycoprotein gp70 behaves as an acute phase reactant

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

    Hara, I.; Izui, S.; Dixon, F.J.

    1982-02-01

    A single intraperitoneal injection of bacterial lipopolysaccharide (LPS) or its lipid A component induced high levels of glycoprotein, gp70, in sera of several strains of mice within 24 h. This serum gp70 response induced by LPS was independent of the activation of B cells and the presence of T cells. However, serological and immunohistochemical studies demonstrated the production of gp70 by hepatic parenchymal cells and its subsequent release into the circulating blood. The expression of gp70 in the serum was enhanced not only by LPS but also other inducers of acute phase reactants (APR) such as turpentine oil or polyriboinosinic-polyribocytidylicmore » acid. Further, the serum gp70 response was kinetically identical to those of APR. These results strongly suggest that (a) the liver may be the major source for serum gp70, (b) serum gp70 behaves like an APR, (c) its expression may be controlled by a mechanism similar to that for other APR, and (d) this glycoprotein apparently behaves as a normal host constituent and not a product of a viral genome.« less

  13. Biosynthesis of t-Butyl in Apratoxin A: Functional Analysis and Architecture of a PKS Loading Module.

    PubMed

    Skiba, Meredith A; Sikkema, Andrew P; Moss, Nathan A; Lowell, Andrew N; Su, Min; Sturgis, Rebecca M; Gerwick, Lena; Gerwick, William H; Sherman, David H; Smith, Janet L

    2018-05-08

    The unusual feature of a t-butyl group is found in several marine-derived natural products including apratoxin A, a Sec61 inhibitor produced by the cyanobacterium Moorea bouillonii PNG 5-198. Here, we determine that the apratoxin A t-butyl group is formed as a pivaloyl acyl carrier protein (ACP) by AprA, the polyketide synthase (PKS) loading module of the apratoxin A biosynthetic pathway. AprA contains an inactive "pseudo" GCN5-related N-acetyltransferase domain (ΨGNAT) flanked by two methyltransferase domains (MT1 and MT2) that differ distinctly in sequence. Structural, biochemical, and precursor incorporation studies reveal that MT2 catalyzes unusually coupled decarboxylation and methylation reactions to transform dimethylmalonyl-ACP, the product of MT1, to pivaloyl-ACP. Further, pivaloyl-ACP synthesis is primed by the fatty acid synthase malonyl acyltransferase (FabD), which compensates for the ΨGNAT and provides the initial acyl-transfer step to form AprA malonyl-ACP. Additionally, images of AprA from negative stain electron microscopy reveal multiple conformations that may facilitate the individual catalytic steps of the multienzyme module.

  14. Influenza vaccination prevalence and demographic factors of patients and GPs in primary care in Austria and Croatia: a cross-sectional comparative study in the framework of the APRES project.

    PubMed

    Hoffmann, Kathryn; Paget, John; Wojczewski, Silvia; Katic, Milica; Maier, Manfred; Soldo, Dragan

    2016-06-01

    The aim of this study was to compare influenza vaccination coverage rates in Austria and Croatia, countries with missing data in the Eurosurveillance and European Centre for Disease Prevention and Control reports. In addition, we assessed demographic factors of GPs and patients and calculated associations regarding vaccination rates. This cross-sectional study was conducted within the context of thethe appropriateness of prescribing antibiotics in primary health care in Europe with respect to antibiotic resistance (APRES) project. Between November 2010 and July 2011, 40 GP practices attempted to recruit 200 patients to complete questionnaires about their influenza vaccination status and demographics. Statistical analyses included subgroup analyses and logistic regression models. Data from 7269 patient questionnaires could be analyzed (3309 Austria and 3960 Croatia). The vaccination coverage rates were low (2009/2010: A 18.2 vs. C 20.9%, P < 0.001; 2010/2011: A 13.7 vs. C 18.6%; P < 0.001). The rates were found to be highest in persons aged 65 years and older (2009/2010: A 35.1 vs. C 49.5%, P < 0.001; 2010/2011: A 31.1 vs. C 45.7%, P < 0.001) and lowest in children (2009/2010: A 8.5 vs. C 2.0%, P < 0.001; 2010/2011: A 4.3 vs. C 1.6%, P = 0.002). Besides, demographics in the adjusted regression model for Austria being vaccinated was associated with consulting a female GP (OR, 4.20; P < 0.001) and in Croatia with five or more GP consultations per year (OR, 4.41; P < 0.001). The vaccination coverage rates for Austria and Croatia were low, with the highest rates found in persons aged 65 years and older, showing that public coverage of the vaccination costs might increase vaccination rates. However, other factors seem to be relevant, including the engagement of GPs. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  15. JPRS Report, Soviet Union, USSR: Materials Science

    DTIC Science & Technology

    1988-08-24

    Interaction of Metal Melt With Carbon Fiber [T.A. Chernyshova , N.L. Bolotov, et al.; FIZIKA I KHIMIYA OBRABOTKI MATERIALOV, No 2, Mar-Apr 88] 6 Ferrous...manuscript received 27 Apr 87) pp 88-92 [Article by T.A. Chernyshova , N.L. Bolotov, L.I. Kobe- leva, M.P. Arsentyeva and K.P. Gurov, Moscow] [Abstract] An

  16. Affordability Constraints in Major Defense Acquisitions

    DTIC Science & Technology

    2016-11-01

    Fence Inc 1 30-May-2014 4-Oct-2012 4-Nov-2015 32 SSC 5-Jul-2012 33 VH-92A (VXX) 5-Apr-2013 17-Apr-2014 34 FAB -T CPT 26-Oct...Development EPAWSS Eagle Passive/Active Warning and Survivability System EPP Extended Planning Period EPS Enhanced Polar System FAB -T CPT Family of

  17. BOREAS Level-0 TIMS Imagery: Digital Counts in BIL Format

    NASA Technical Reports Server (NTRS)

    Newcomer, Jeffrey A.; Dominquez, Roseanne; Hall, Forrest G. (Editor)

    2000-01-01

    For BOREAS, the TIMS imagery, along with the other remotely sensed images, was collected to provide spatially extensive information over the primary study areas. The level-0 TIMS images cover the time periods of 16-Apr-1994 to 20-Apr-1994 and 06-Sep-1994 to 17-Sep-1994. The images are available in their original uncalibrated format.

  18. Outcomes of abdominoperineal resection for management of anal cancer in HIV-positive patients: a national case review.

    PubMed

    Leeds, Ira L; Alturki, Hasan; Canner, Joseph K; Schneider, Eric B; Efron, Jonathan E; Wick, Elizabeth C; Gearhart, Susan L; Safar, Bashar; Fang, Sandy H

    2016-08-05

    The incidence of anal cancer in human immunodeficiency virus (HIV)-positive individuals is increasing, and how co-infection affects outcomes is not fully understood. This study sought to describe the current outcome disparities between anal cancer patients with and without HIV undergoing abdominoperineal resection (APR). A retrospective review of all US patients diagnosed with anal squamous cell carcinoma, undergoing an APR, was performed. Cases were identified using a weighted derivative of the Healthcare Utilization Project's National Inpatient Sample (2000-2011). Patients greater than 60 years old were excluded after finding a skewed population distribution between those with and without HIV infection. Multivariable logistic regression and generalized linear modeling analysis examined factors associated with postoperative outcomes and cost. Perioperative complications, in-hospital mortality, length of hospital stay, and hospital costs were compared for those undergoing APR with and without HIV infection. A total of 1725 patients diagnosed with anal squamous cell cancer undergoing APR were identified, of whom 308 (17.9 %) were HIV-positive. HIV-positive patients were younger than HIV-negative patients undergoing APR for anal cancer (median age 47 years old versus 51 years old, p < 0.001) and were more likely to be male (95.1 versus 30.6 %, p < 0.001). Postoperative hemorrhage was more frequent in the HIV-positive group (5.1 versus 1.5 %, p = 0.05). Mortality was low in both groups (0 % in HIV-positive versus 1.49 % in HIV-negative, p = 0.355), and length of stay (LOS) (10+ days; 75th percentile of patient data) was similar (36.9 % with HIV versus 29.8 % without HIV, p = 0.262). Greater hospitalization costs were associated with patients who experienced a complication. However, there was no difference in hospitalization costs seen between HIV-positive and HIV-negative patients (p = 0.66). HIV status is not associated with worse

  19. Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics.

    PubMed

    Lusk, M Josephine; Garden, Frances L; Rawlinson, William D; Naing, Zin W; Cumming, Robert G; Konecny, Pam

    2016-05-01

    Studies examining cervicitis aetiology and prevalence lack comparability due to varying criteria for cervicitis. We aimed to outline cervicitis associations and suggest a best case definition. A cross-sectional study of 558 women at three sexually transmitted infection clinics in Sydney, Australia, 2006-2010, examined pathogen and behavioural associations of cervicitis using three cervicitis definitions: 'microscopy' (>30 pmnl/hpf (polymorphonuclear leucocytes per high-powered field on cervical Gram stain)), 'cervical discharge' (yellow and/or mucopurulent cervical discharge) or 'micro+cervical discharge' (combined 'microscopy' and 'cervical discharge'). Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Trichomonas vaginalis (TV) and Neisseria gonorrhoeae (NG) had the strongest associations with cervicitis definitions 'micro+cervical discharge': CT adjusted prevalence ratio (APR)=2.13 (95% CI 1.38 to 3.30) p=0.0006, MG APR=2.21 (1.33 to 3.69) p=0.002, TV APR=2.37 (1.44 to 3.90) p=0.0007 NG PR=4.42 (3.79 to 5.15) p<0.0001 and 'cervical discharge': CT APR=1.90 (1.25 to 2.89) p=0.003, MG APR=1.93 (1.17 to 3.19) p=0.011, TV APR=2.02 (1.24 to 3.31) p=0.005 NG PR=3.88 (3.36 to 4.48) p<0.0001. Condom use for vaginal sex 'always/sometimes' reduced cervicitis risk: ('micro+cervical discharge') APR=0.69 (0.51 to 0.93) p=0.016. Combined population attributable risk % (PAR%) of these four pathogens was only 18.0% with a protective PAR% of condoms of 25.7%. Exposures not associated with cervicitis included bacterial vaginosis, Mycoplasma hominis, Ureaplasma urealyticum, herpes simplex virus 1&2, cytomegalovirus, Candida, age, smoking and hormonal contraception. Cervicitis was associated with CT, MG, TV and NG with combined PAR% of these pathogens only 18% in this setting, suggesting other factors are involved. Condoms significantly reduced cervicitis risk. Cervicitis definitions with best clinical utility and pathogen prediction were 'cervical discharge' and 'micro

  20. Cervical Cancer Screening in the US–Mexico Border Region: A Binational Analysis

    PubMed Central

    Schiefelbein, Emily L.; Smith, Ruben; Rojas, Rosalba; Mirchandani, Gita G.; McDonald, Jill A.

    2015-01-01

    Cervical cancer mortality is high along the US–Mexico border. We describe the prevalence of a recent Papanicolaou screening test (Pap) among US and Mexican border women. We analyzed 2006 cross-sectional data from Mexico’s National Survey of Health and Nutrition and the US Behavioral Risk Factor Surveillance System. Women aged 20–77 years in 44 US border counties (n = 1,724) and 80 Mexican border municipios (n = 1,454) were studied. We computed weighted proportions for a Pap within the past year by age, education, employment, marital status, health insurance, health status, risk behaviors, and ethnicity and adjusted prevalence ratios (APR) for the US, Mexico, and the region overall. Sixty-five percent (95 %CI 60.3–68.6) of US women and 32 % (95 %CI 28.7–35.2) of Mexican women had a recent Pap. US residence (APR = 2.01, 95 %CI 1.74–2.33), marriage (APR = 1.31, 95 %CI 1.17–1.47) and insurance (APR = 1.38, 95 %CI 1.22–1.56) were positively associated with a Pap test. Among US women, insurance and marriage were associated (APR = 1.21, 95 %CI 1.05–1.38 and 1.33, 95 %CI 1.10–1.61, respectively), and women aged 20–34 years were about 25 % more likely to have received a test than older women. Insurance and marriage were also positively associated with Pap testing among Mexican women (APR = 1.39, 95 %CI 1.17–1.64 and 1.50; 95 %CI 1.23–1.82, respectively), as were lower levels of education (≤8th grade or 9th–12th grade versus some college) (APR = 1.74; 95 %CI 1.21–2.52 and 1.60; 95 %CI 1.03–2.49, respectively). Marriage and insurance were associated with a recent Pap test on both sides of the border. Binational insurance coverage increases and/or cost reductions might bolster testing among unmarried and uninsured women, leading to earlier cervical cancer diagnosis and potentially lower mortality. PMID:22965734

  1. Recent Transmission of Tuberculosis - United States, 2011-2014.

    PubMed

    Yuen, Courtney M; Kammerer, J Steve; Marks, Kala; Navin, Thomas R; France, Anne Marie

    2016-01-01

    Tuberculosis is an infectious disease that may result from recent transmission or from an infection acquired many years in the past; there is no diagnostic test to distinguish the two causes. Cases resulting from recent transmission are particularly concerning from a public health standpoint. To describe recent tuberculosis transmission in the United States, we used a field-validated plausible source-case method to estimate cases likely resulting from recent transmission during January 2011-September 2014. We classified cases as resulting from either limited or extensive recent transmission based on transmission cluster size. We used logistic regression to analyze patient characteristics associated with recent transmission. Of 26,586 genotyped cases, 14% were attributable to recent transmission, 39% of which were attributable to extensive recent transmission. The burden of cases attributed to recent transmission was geographically heterogeneous and poorly predicted by tuberculosis incidence. Extensive recent transmission was positively associated with American Indian/Alaska Native (adjusted prevalence ratio [aPR] = 3.6 (95% confidence interval [CI] 2.9-4.4), Native Hawaiian/Pacific Islander (aPR = 3.2, 95% CI 2.3-4.5), and black (aPR = 3.0, 95% CI 2.6-3.5) race, and homelessness (aPR = 2.3, 95% CI 2.0-2.5). Extensive recent transmission was negatively associated with foreign birth (aPR = 0.2, 95% CI 0.2-0.2). Tuberculosis control efforts should prioritize reducing transmission among higher-risk populations.

  2. Recent Transmission of Tuberculosis — United States, 2011–2014

    PubMed Central

    Yuen, Courtney M.; Kammerer, J. Steve; Marks, Kala; Navin, Thomas R.; France, Anne Marie

    2016-01-01

    Tuberculosis is an infectious disease that may result from recent transmission or from an infection acquired many years in the past; there is no diagnostic test to distinguish the two causes. Cases resulting from recent transmission are particularly concerning from a public health standpoint. To describe recent tuberculosis transmission in the United States, we used a field-validated plausible source-case method to estimate cases likely resulting from recent transmission during January 2011–September 2014. We classified cases as resulting from either limited or extensive recent transmission based on transmission cluster size. We used logistic regression to analyze patient characteristics associated with recent transmission. Of 26,586 genotyped cases, 14% were attributable to recent transmission, 39% of which were attributable to extensive recent transmission. The burden of cases attributed to recent transmission was geographically heterogeneous and poorly predicted by tuberculosis incidence. Extensive recent transmission was positively associated with American Indian/Alaska Native (adjusted prevalence ratio [aPR] = 3.6 (95% confidence interval [CI] 2.9–4.4), Native Hawaiian/Pacific Islander (aPR = 3.2, 95% CI 2.3–4.5), and black (aPR = 3.0, 95% CI 2.6–3.5) race, and homelessness (aPR = 2.3, 95% CI 2.0–2.5). Extensive recent transmission was negatively associated with foreign birth (aPR = 0.2, 95% CI 0.2–0.2). Tuberculosis control efforts should prioritize reducing transmission among higher-risk populations. PMID:27082644

  3. Orofacial and respiratory tardive dyskinesia: potential side effects of 2-dimethylaminoethanol (deanol)?

    PubMed

    Haug, B A; Holzgraefe, M

    1991-01-01

    A case of essential tremor since early adultness is presented, which has been treated successfully with the acetylcholine precursor 2-dimethylaminoethanol (deanol) for 10 years. Development of a marked dyskinesia syndrome affecting predominantly orofacial and respiratory musculature has been noticed with this medication. Partial remission after discontinuation and a favorable response to anticholinergics are suggestive of an adverse drug effect.

  4. Senior Noncommissioned Officers’ APR Opinion Survey

    DTIC Science & Technology

    1977-02-01

    the number of NCOs who chow each response alternative on each Item of the questionnaire. Secondly, it wE necessaty to make comparisons among NCOs... aRting Faton Ranked Differentiallyt by Grade Rank Giva , Rating Pastor 11? as to Ability to Train Others 20 24 26 .Pofessional Qualities 10 15 17...experience necessaty to evaluate senior NCOs. Many aldo thought that an unhealthy conflict of Interest arises when a senior NCO Is evaluated by another

  5. Prospective comparison of two models of integrating early infant male circumcision with maternal child health services in Kenya: The Mtoto Msafi Mbili Study

    PubMed Central

    Adera, Fredrick; Mackesy-Amiti, Mary Ellen; Adipo, Timothy; Nordstrom, Sherry K.; Mehta, Supriya D.; Jaoko, Walter; Langi, F. L. Fredrik G.; Obiero, Walter; Obat, Edmon; Otieno, Fredrick O.; Young, Marisa R.

    2017-01-01

    As countries scale up adult voluntary medical male circumcision (VMMC) for HIV prevention, they are looking ahead to long term sustainable strategies, including introduction of early infant male circumcision (EIMC). To address the lack of evidence regarding introduction of EIMC services in sub-Saharan African settings, we conducted a simultaneous, prospective comparison of two models of EIMC service delivery in Homa Bay County, Kenya. In one division a standard delivery package (SDP) was introduced and included health facility-based provision of EIMC services with community engagement for client referral versus in a different division a standard package plus (SDPplus) that included community-delivered EIMC services. Babies 1–60 days old were eligible for EIMC. A representative sample of mothers and fathers of baby boys at 16 health facilities was surveyed. We examined differences between mothers and fathers in the SDP and SDPplus divisions and identified factors associated with EIMC uptake. We report adjusted prevalence ratios (aPR). Of 1660 mothers interviewed, 1501 (89%) gave approval to contact the father, and 1259 fathers (84%) were interviewed. The proportion of babies circumcised was slightly greater in the SDPplus division than the SDP division (27.3% vs 23.7%), but the difference was not significant (p = 0.08). In adjusted analyses, however, the prevalence of babies being circumcised was greater in the SDPplus division (aPR = 1.23, 95% CI:1.04–1.45) and the factors associated with a baby being circumcised were the mother having received information about EIMC (during pregnancy, aPR = 4.81, 95% CI: 2.21–3.42), having discussed circumcision with the father if married or cohabiting (aPR = 5.39, 95% CI: 3.31–8.80) or being single (aPR = 5.67, 95% CI: 3.31–9.69), perceiving herself to be living with HIV (aPR = 1.39, 95% CI: 1.15–1.67), or having a post-secondary education (aPR = 1.33, 95% CI: 1.04–1.69), and the father being Muslim (aPR = 1.85, 95

  6. New X-ray outburst of accreting millisecond pulsar SWIFT J1756.9-2508 detected by INTEGRAL

    NASA Astrophysics Data System (ADS)

    Mereminskiy, I. A.; Grebenev, S. A.; Krivonos, R. A.; Sunyaev, R. A.

    2018-04-01

    During recent observations (1-2 Apr 2018, PI: E.Bozzo) of the weak X-ray burster IGR J17379-3747 (#11447,#11487, Chelovekov et al. 2006, AstL, 32, 456) and regular observations of Galactic center region (2-3 Apr 2018, PI: R.A. Sunyaev) we detected a new X-ray transient in 20-60 keV sky maps obtained by IBIS/ISGRI.

  7. Annual Research Progress Report FY 92.

    DTIC Science & Technology

    1993-01-11

    and Toxic Exposures B ronchial m ucin .................................................................. 12 Enriquez, John 1 .: 90/13 (T) The Effect of...Bast RC: Fibronectin is an immunosuppressive Pearl W, Zeballos R, Gregors G, Connery S, substance associated with epithelial ovarian Weisman 1 : Effects ...Symposium. 30 Sonthofen, Germany, Apr 92. Apr-03 May 92. Donovan M: Maxillofacial Reconstruction Using Weisman 1 : Presence of SOT and the Effect on

  8. Improved Therapeutic Regimens for Treatment of Post-Traumatic Ocular Infections

    DTIC Science & Technology

    2009-05-01

    TITLE: Improved Therapeutic Regimens for Treatment of Post- Traumatic Ocular Infections PRINCIPAL INVESTIGATOR: Michelle C. Callegan, Ph.D...From - To) 15 APR 2008 - 14 APR 2009 4. TITLE AND SUBTITLE Improved Therapeutic Regimens for Treatment of Post-Traumatic 5a. CONTRACT NUMBER...delay between injury and adequate treatment . This proposal was designed to analyze the effectiveness of antibiotics, anti- inflammatory drugs, and non

  9. Press Room

    Science.gov Websites

    Event Archives ARC at ... ARC Members Honored as Fellows at SAE World Congress (Apr. 10, 2018) ARC Researchers at the 2018 SAE World Congress (Apr. 10-12, 2018, SAE) Dr. Lionel Robert on how and whether remarks at 23rd ARC Annual Program Review (May 9-10, ME) ARC Researchers at the 2017 SAE World Congress

  10. Prise en charge des corps étrangers enclaves de l’œsophage: à propos de 36 cas

    PubMed Central

    Togo, Seydou; Ouattara, Moussa Abdoulaye; Li, Xing; Yang, Shang Wen; Koumaré, Sékou

    2017-01-01

    L'ingestion de corps étranger de l'œsophage est un motif fréquent de consultation aux urgences pédiatriques. Cependant le phénomène peut se retrouver à tous les âges. Les auteurs décrivent les caractéristiques cliniques, paracliniques et thérapeutiques des corps étrangers enclavés dans l'œsophage pris en charge à l'hôpital du Mali. Il s'agit d'une étude prospective, menée entre janvier 2011 et décembre 2014 incluant tous les cas d'ingestion de corps étrangers enclavés dans l'œsophage. Au total 36 patients ont été pris en charge par des moyens endoscopiques ou chirurgicaux. L'âge moyen était de 6 ans (extrêmes: 14 mois- 62 ans). Le sexe masculin était dominant avec un sexe ratio de 1,75. Les corps étrangers étaient bloqués dans le rétrécissement crico-pharyngien dans 69,45% des cas suivi du rétrécissement aortique dans 22,22% des cas. Le délai d'extraction du corps étranger en moyenne était de 7 heures 30. La fibroscopie rigide a permis l'extraction du corps étranger dans 88,89% des cas. Une chirurgie par thoracotomie a permis d'extraire le corps étranger dans 5,55%. Les corps étrangers de l'œsophage peuvent se retrouver à tout âge mais restent plus fréquent chez l'enfant. L'extraction endoscopique est la man'uvre la plus réalisée mais la chirurgie pour extraction d'un corps étranger bloqué dans l'œsophage bien que rare reste le dernier recours à cause souvent de leur nature et de la survenue des complications. Le meilleur moyen pour lutter contre ces accidents reste la prévention. PMID:28904731

  11. [Beginning Knowledge of Transfusion in Japan].

    PubMed

    Mazda, Toshio; Shimizu, Masaru

    2015-01-01

    Blood components and plasma derivatives are two of the most useful tools in modern medicine. When the Portuguese opened the maritime routes to the Far East in the 16th century. Western medicine traveled to Japan on the trading vessels that carried physicians and barber-surgeons to care for the body and Christian missionaries to care for the soul. Skilled interpreters such as Kōgyū Yoshio translated and studied Dutch editions of early medical books, like Lorenz Heister's "Chirurgie" (Nürnberg, 1719), that illustrate the concept of transfusion. The oldest description of transfusion originating in Japan is a handwritten manuscript entitled "Bansui Sensi Chojutsu Shomoku" by Masamichi Nishijima, a student of Bansui Otsuki. It is a list of Otsuki's translated works. He described book names and chapter names in the manuscript, and when he finished translation of a chapter, he marked a circle on the chapter name. The transfusion chapter had a circle. That dates the earliest writing on transfusion in Japanese to 1804, shortly after the death of Kōgyū. Unfortunately, the manuscript translation no longer exists. In 1814, Shunzō Yoshio, grandson of Kōgyū, and in 1820, Tokki Koshimura, translated the figure legends of "Chirurgie." Soon afterwards, after the first report of transfusion from human-to-human by James Blundell in London in 1818, Western medical books published on the subject began to arrive. The works of Christoph Wilhelm Hufeland, Georg Friedrich Most and Carl Canstatt all mentioning transfusion, albeit without details, were translated by Kōan Ogata and Shinryō Tsuboi. During the Edo period, Japan was a closed country; only open to the Dutch through a tiny island in Nagasaki. But Japanese doctors in the Edo period learned about blood transfusion through Dutch-translated versions of Western medical Books. Transfusion began being practiced in Japan in 1919, almost exactly 100 years after the concept was introduced

  12. Clinical features of movement disorders.

    PubMed

    Yung, C Y

    1983-08-01

    The descriptive aspects of all types of movement disorders and their related syndromes and terminologies used in the literature are reviewed and described. This comprises the features of (a) movement disorders secondary to neurological diseases affecting the extrapyramidal motor system, such as: athetosis, chorea, dystonia, hemiballismus, myoclonus, tremor, tics and spasm, (b) drug induced movement disorders, such as: akathisia, akinesia, hyperkinesia, dyskinesias, extrapyramidal syndrome, and tardive dyskinesia, and (c) abnormal movements in psychiatric disorders, such as: mannerism, stereotyped behaviour and psychomotor retardation. It is intended to bring about a more comprehensive overview of these movement disorders from a phenomenological perspective, so that clinicians can familiarize with these features for diagnosis. Some general statements are made in regard to some of the characteristics of movement disorders.

  13. Plasma prolactin and homovanillic acid as markers for psychopathology and abnormal movements after neuroleptic dose decrease.

    PubMed

    Newcomer, J W; Riney, S J; Vinogradov, S; Csernansky, J G

    1992-01-01

    Plasma prolactin concentration (pPRL), plasma homovanillic acid concentration (pHVA), and symptomatology were measured in 24 male subjects with schizophrenia during maintenance haloperidol treatment. Fourteen subjects subsequently underwent 50 percent dose decreases under placebo-controlled, double-blind conditions. At baseline, a significant inverse correlation was found between pPRL and both tardive dyskinesia (TD) and "thinking disorder"; pPRL was directly correlated with negative symptoms. No such relationship was found with pHVA. In the patients who underwent a dose decrease, no relationship was found between baseline pPRL or pHVA and any clinical variable after the decrease. These data do not support the use of baseline pPRL or pHVA as markers of central dopamine function subsequent to a neuroleptic dose decrease.

  14. Hydrogen production through aqueous-phase reforming of ethylene glycol in a washcoated microchannel.

    PubMed

    D'Angelo, M Fernanda Neira; Ordomsky, Vitaly; Paunovic, Violeta; van der Schaaf, John; Schouten, Jaap C; Nijhuis, T Alexander

    2013-09-01

    Aqueous-phase reforming (APR) of biocarbohydrates is conducted in a catalytically stable washcoated microreactor where multiphase hydrogen removal enhances hydrogen efficiency. Single microchannel experiments are conducted following a simplified model based on the microreactor concept. A coating method to deposit a Pt-based catalyst on the microchannel walls is selected and optimized. APR reactivity tests are performed by using ethylene glycol as the model compound. Optimum results are achieved with a static washcoating technique; a highly uniform and well adhered 5 μm layer is deposited on the walls of a 320 μm internal diameter (ID) microchannel in one single step. During APR of ethylene glycol, the catalyst layer exhibits high stability over 10 days after limited initial deactivation. The microchannel presents higher conversion and selectivity to hydrogen than a fixed-bed reactor. The benefits of using a microreactor for APR can be further enhanced by utilizing increased Pt loadings, higher reaction temperatures, and larger carbohydrates (e.g., glucose). The use of microtechnology for aqueous-phase reforming will allow for a great reduction in the reformer size, thus rendering it promising for distributed hydrogen production. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Undernutrition, the Acute Phase Response to Infection, and Its Effects on Micronutrient Status Indicators12

    PubMed Central

    Bresnahan, Kara A.; Tanumihardjo, Sherry A.

    2014-01-01

    Infection and undernutrition are prevalent in developing countries and demonstrate a synergistic relation. Undernutrition increases infection-related morbidity and mortality. The acute phase response (APR) is an innate, systemic inflammatory reaction to a wide array of disruptions in a host’s homeostasis, including infection. Released from immune cells in response to deleterious stimuli, proinflammatory cytokines act on distant tissues to induce behavioral (e.g., anorexia, weakness, and fatigue) and systemic effects of the APR. Cytokines act to increase energy and protein requirements to manifest fever and support hepatic acute phase protein (APP) production. Blood concentrations of glucose and lipid are augmented to provide energy to immune cells in response to cytokines. Additionally, infection decreases intestinal absorption of nutrients and can cause direct loss of micronutrients. Traditional indicators of iron, zinc, and vitamin A status are altered during the APR, leading to inaccurate estimations of deficiency in populations with a high or unknown prevalence of infection. Blood concentrations of APPs can be measured in nutrition interventions to assess the time stage and severity of infection and correct for the APR; however, standardized cutoffs for nutrition applications are needed. Protein-energy malnutrition leads to increased gut permeability to pathogens, abnormal immune cell populations, and impaired APP response. Micronutrient deficiencies cause specific immune impairments that affect both innate and adaptive responses. This review describes the antagonistic interaction between the APR and nutritional status and emphasizes the need for integrated interventions to address undernutrition and to reduce disease burden in developing countries. PMID:25398733

  16. Variation in Sulfur and Selenium Accumulation Is Controlled by Naturally Occurring Isoforms of the Key Sulfur Assimilation Enzyme ADENOSINE 5′-PHOSPHOSULFATE REDUCTASE2 across the Arabidopsis Species Range1[W][OPEN

    PubMed Central

    Chao, Dai-Yin; Baraniecka, Patrycja; Danku, John; Koprivova, Anna; Lahner, Brett; Luo, Hongbing; Yakubova, Elena; Dilkes, Brian; Kopriva, Stanislav; Salt, David E.

    2014-01-01

    Natural variation allows the investigation of both the fundamental functions of genes and their role in local adaptation. As one of the essential macronutrients, sulfur is vital for plant growth and development and also for crop yield and quality. Selenium and sulfur are assimilated by the same process, and although plants do not require selenium, plant-based selenium is an important source of this essential element for animals. Here, we report the use of linkage mapping in synthetic F2 populations and complementation to investigate the genetic architecture of variation in total leaf sulfur and selenium concentrations in a diverse set of Arabidopsis (Arabidopsis thaliana) accessions. We identify in accessions collected from Sweden and the Czech Republic two variants of the enzyme ADENOSINE 5′-PHOSPHOSULFATE REDUCTASE2 (APR2) with strongly diminished catalytic capacity. APR2 is a key enzyme in both sulfate and selenate reduction, and its reduced activity in the loss-of-function allele apr2-1 and the two Arabidopsis accessions Hodonín and Shahdara leads to a lowering of sulfur flux from sulfate into the reduced sulfur compounds, cysteine and glutathione, and into proteins, concomitant with an increase in the accumulation of sulfate in leaves. We conclude from our observation, and the previously identified weak allele of APR2 from the Shahdara accession collected in Tadjikistan, that the catalytic capacity of APR2 varies by 4 orders of magnitude across the Arabidopsis species range, driving significant differences in sulfur and selenium metabolism. The selective benefit, if any, of this large variation remains to be explored. PMID:25245030

  17. Comparison of abdominoperineal resection and low anterior resection in lower and middle rectal cancer.

    PubMed

    Omidvari, Shapour; Hamedi, Sayed Hasan; Mohammadianpanah, Mohammad; Razzaghi, Samira; Mosalaei, Ahmad; Ahmadloo, Niloofar; Ansari, Mansour; Pourahmad, Saeideh

    2013-09-01

    This study aimed to investigate local control and survival rates following abdominoperineal resection (APR) compared with low anterior resection (LAR) in lower and middle rectal cancer. In this retrospective study, 153 patients with newly histologically proven rectal adenocarcinoma located at low and middle third that were treated between 2004 and 2010 at a tertiary hospital. The tumors were pathologically staged according to the 7th edition of the American Joint Committee on Cancer (AJCC) staging system. Surgery was applied for 138 (90%) of the patients, of which 96 (70%) underwent LAR and 42 were (30%) treated with APR. Total mesorectal excision was performed for all patients. In addition, 125 patients (82%) received concurrent (neoadjuvant, adjuvant or palliative) pelvic chemoradiation, and 134 patients (88%) received neoadjuvant, adjuvant or concurrent chemotherapy. Patients' follow-up ranged from 4 to 156 (median 37) months. Of 153 patients, 89 were men and 64 were women with a median age of 57 years. One patient (0.7%) was stage 0, 15 (9.8%) stage I, 63 (41.2%) stage II, 51 (33.3%) stage III and 23 (15%) stage IV. There was a significant difference between LAR and APR in terms of tumor distance from anal verge, disease stage and combined modality therapy used. However, there was no significant difference regarding 5-year local control, disease free and overall survival rates between LAR and APR. LAR can provide comparable local control, disease free and overall survival rates compared with APR in eligible patients with lower and middle rectal cancer. Copyright © 2013. Production and hosting by Elsevier B.V.

  18. A startling acoustic stimulus facilitates voluntary lower extremity movements and automatic postural responses in people with chronic stroke.

    PubMed

    Coppens, Milou J M; Roelofs, Jolanda M B; Donkers, Nicole A J; Nonnekes, Jorik; Geurts, Alexander C H; Weerdesteyn, Vivian

    2018-05-14

    A startling acoustic stimulus (SAS) involuntary releases prepared movements at accelerated latencies, known as the StartReact effect. Previous work has demonstrated intact StartReact in paretic upper extremity movements in people after stroke, suggesting preserved motor preparation. The question remains whether motor preparation of lower extremity movements is also unaffected after stroke. Here, we investigated StartReact effects on ballistic lower extremity movements and on automatic postural responses (APRs) following perturbations to standing balance. These APRs are particularly interesting as they are critical to prevent a fall following balance perturbations, but show substantial delays and poor muscle coordination after stroke. Twelve chronic stroke patients and 12 healthy controls performed voluntary ankle dorsiflexion movements in response to a visual stimulus, and responded to backward balance perturbations evoking APRs. Twenty-five percent of all trials contained a SAS (120 dB) simultaneously with the visual stimulus or balance perturbation. As expected, in the absence of a SAS muscle and movement onset latencies at the paretic side were delayed compared to the non-paretic leg and to controls. The SAS accelerated ankle dorsiflexion onsets in both the legs of the stroke subjects and in controls. Following perturbations, the SAS accelerated bilateral APR onsets not only in controls, but for the first time, we also demonstrated this effect in people after stroke. Moreover, APR inter- and intra-limb muscle coordination was rather weak in our stroke subjects, but substantially improved when the SAS was applied. These findings show preserved movement preparation, suggesting that there is residual (subcortical) capacity for motor recovery.

  19. Factors Associated with Participation in Pulmonary Tuberculosis Screening Using Chest X-Ray among Diabetes Mellitus Type II Patients in Denpasar, Bali, Indonesia.

    PubMed

    Putra, I Gusti Ngurah Edi; Astuti, Putu Ayu Swandewi; Suarjana, I Ketut; Mulyawan, Ketut Hari; Duana, I Made Kerta; Kurniasari, Ni Made Dian; Putra, I Wayan Gede Artawan Eka

    2018-01-01

    Diabetes mellitus (DM) increases the risk of developing pulmonary tuberculosis (TB) disease. Therefore, pulmonary TB screening among DM patients is essential. This study aimed to identify factors associated with participation of DM type II patients in pulmonary TB screening using chest X-ray. This was a cross-sectional analytic study and was part of TB-DM screening study in Denpasar, Bali, Indonesia. The sample consisted of 365 DM type II patients selected by quota sampling among DM type II patients joining the screening program from January until March 2016 in 11 public health centres in Denpasar. Data were collected via structured interviews. The contributing factors were determined by modified Poisson regression test for cross-sectional data. From the findings, less than half (45.48%) of DM type II patients participated in chest X-ray examination for TB. Factors associated with participation in pulmonary TB screening were having a higher educational level [APR = 1.34, 95% CI (1.07-1.67)], having family member who developed pulmonary TB disease [APR = 1.47, 95% CI (1.12-1.93)], the travel time to referral hospital for screening being ≤ 15 minutes [APR = 1.6, 95% CI (1.26-2.03)], having health insurance [APR = 2.69, 95% CI (1.10-6.56)], and receiving good support from health provider [APR = 1.35, 95% CI (1.06-1.70)]. Therefore, training for health provider on providing counselling, involvement of family members in screening process, and improving the health insurance coverage and referral system are worth considering.

  20. Crystal methamphetamine use and its correlates in women engaged in sex work in a developing country setting.

    PubMed

    Shokoohi, Mostafa; Karamouzian, Mohammad; Sharifi, Hamid; Rahimi-Movaghar, Afarin; Carrico, Adam W; Hosseini Hooshyar, Samira; Mirzazadeh, Ali

    2018-04-01

    Worldwide, crystal methamphetamine (CM) use and associated high-risk sexual behaviors are a concern, but they are less studied among female sex workers (FSW) in developing countries. This study aimed to characterize the prevalence and individual, interpersonal, and structural correlates of self-reported past-month CM use among FSW in Iran. FSW aged ≥ 18 years who reported penetrative sex with more than one client in the last year were recruited (analytic sample: 1295). Data were collected in one-on-one interviews using a standardized behavioral questionnaire. Poisson regression model was used to assess the correlated of past-month self-reported CM use by crude and adjusted prevalence ratio (APR) and 95% confidence intervals (CI). Non-injecting and injecting CM use was reported by 15.0% (95% CI: 8.7, 24.7) and 0.9% (95% CI: 0.4, 2.1) of participants. CM use was positively associated with concurrent use of opioids (APR from 2.08 to 3.84, P-value < 0.01), higher number of sexual partners (APR: 2.05, P-value: 0.018), housing instability (APR: 3.54, P-value: 0.001), and history of forced sex (APR: 1.47, P-value: 0.050). A considerable number of FSWs use CM along with opioids, have a higher number of sexual partners, forced sex, and housing instability. Both prevention strategies as well as strategies to reduce harm associated with CM need to be added to current programs that predominantly focus on opioid dependency and male drug injectors. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Europe/Latin America Report, Science and Technology

    DTIC Science & Technology

    1997-01-16

    Space Accord 3 AUTOMOBILE INDUSTRY Volvo Chief Attacks Japanese Car Manufacturers’ Tactics in Sweden (SVENSKA DAGBLADET, 21 Nov 86) 4...Great Britain (BIOTEC, Apr 86) 10 EEC’s 1982-86 Biotechnology Programs (BIOTEC, Apr 86) 11 - a Industry , Universities Meet in Italy on...Epitaxy Devices (S. Dumontet; ELECTRONIQUE ACTUALITES, 19 Sep 86) 23 Briefs French Indium Phosphide Production 25 SCIENTIFIC AND INDUSTRIAL POLICY

  2. JPRS Report, Science & Technology, China

    DTIC Science & Technology

    1992-06-29

    KEJIRIBAO, 23 Mar 92] 11 Guangdong’s Strategy of Internationalizing High-Tech Industries [Wei Xulin, Qiu Rongsheng, et al.; KEJIGUANLI YANJIU, Mar...Apr 92] 14 Zhou Guangzhao Urges Cooperation Between Research Institutes and Industry [Zhou Guangzhao; ZHONGGUO KEXUE BAO, 6 Mar 92] 19 Liu...of Developing a Modern Cruise Missile for China [Xu Ande; XIANDAIHUA, Apr 92] 24 Discussion of Strategic Shifts in National Defense Industry

  3. The Gibbs Variational Method in Thermodynamics of Equilibrium Plasma: 1. General Conditions of Equilibrium and Stability for One-Component Charged Gas

    DTIC Science & Technology

    2018-04-01

    systems containing ionized gases. 2. Gibbs Method in the Integral Form As per the Gibbs general methodology , based on the concept of heterogeneous...ARL-TR-8348 ● APR 2018 US Army Research Laboratory The Gibbs Variational Method in Thermodynamics of Equilibrium Plasma: 1...ARL-TR-8348 ● APR 2018 US Army Research Laboratory The Gibbs Variational Method in Thermodynamics of Equilibrium Plasma: 1. General

  4. Quasi Static and Dynamic Characterization of Equal Channel Angular Extrusion (ECAE) Processed and Rolled AZ31 Magnesium Alloy Sheet

    DTIC Science & Technology

    2017-04-01

    ARL-TR-8006 ● Apr 2017 US Army Research Laboratory Quasi -Static and Dynamic Characterization of Equal Channel Angular Extrusion...originator. ARL-TR-8006 ● Apr 2017 US Army Research Laboratory Quasi -Static and Dynamic Characterization of Equal Channel Angular...April 2017 2. REPORT TYPE Technical Report 3. DATES COVERED (From - To) April 2015–January 2016 4. TITLE AND SUBTITLE Quasi -Static and Dynamic

  5. FORMAL MODELING, MONITORING, AND CONTROL OF EMERGENCE IN DISTRIBUTED CYBER PHYSICAL SYSTEMS

    DTIC Science & Technology

    2018-02-23

    FORMAL MODELING, MONITORING, AND CONTROL OF EMERGENCE IN DISTRIBUTED CYBER- PHYSICAL SYSTEMS UNIVERSITY OF TEXAS AT ARLINGTON FEBRUARY 2018 FINAL...COVERED (From - To) APR 2015 – APR 2017 4. TITLE AND SUBTITLE FORMAL MODELING, MONITORING, AND CONTROL OF EMERGENCE IN DISTRIBUTED CYBER- PHYSICAL ...dated 16 Jan 09 13. SUPPLEMENTARY NOTES 14. ABSTRACT This project studied emergent behavior in distributed cyber- physical systems (DCPS). Emergent

  6. China Report, Political, Sociological and Military Affairs, No. 420

    DTIC Science & Technology

    1983-05-16

    must observe when we investigate into the socialist Chinese legal system. The legal relations are a kind of social relations. They exist...under investigation for publicly obstructing and hindering the policy on intellectuals and slandering the patriotic returned Overseas Chinese ...Thatcher Hold Anglo-German Summit (XINHUA, 22 Apr 83) 40 Liao Chenghi Receives Brazilian- Chinese Group (ZH0NGGU0 XINWEN SHE, 22 Apr

  7. Wastewater/Storm Water Characterization and Toxicity Identification Evaluation, Sheppard Air Force Base, Texas

    DTIC Science & Technology

    1991-12-01

    support the NPDES permit renewal appl ication. the studies should collect sufficient data to characterize waste streams, including wastewater and WINTP...26Apr 1 30Apr I 1May I 2May Arsenic I uiI ᝺ ᝺i ᝺  ᝺! ᝺ Barium I ug l I i  . 4001 SWot 1000 " 2600 Beryllium J ug 1 ᝺ <o 0 <o

  8. Bio-Based Polyurethane Containing Isosorbide for Use in Composites and Coatings

    DTIC Science & Technology

    2015-04-01

    ARL-TR-7259 ● APR 2015 US Army Research Laboratory Bio-Based Polyurethane Containing Isosorbide for Use in Composites and...copyright notation hereon. ARL-TR-7259 ● APR 2015 US Army Research Laboratory Bio-Based Polyurethane Containing Isosorbide for Use...4. TITLE AND SUBTITLE Bio-Based Polyurethane Containing Isosorbide for Use in Composites and Coatings 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

  9. Permissiveness toward tobacco sponsorship undermines tobacco control support in Africa.

    PubMed

    Ayo-Yusuf, Olalekan A; Olutola, Bukola G; Agaku, Israel T

    2016-06-01

    School personnel, who are respected members of the community, may exert significant influence on policy adoption. This study assessed the impact of school personnel's permissiveness toward tobacco industry sponsorship activities on their support for complete bans on tobacco advertisements, comprehensive smoke-free laws and increased tobacco prices. Representative data were obtained from the Global School Personnel Survey for 29 African countries (n = 17 929). Adjusted prevalence ratios (aPR) were calculated using multi-variable Poisson regression models to assess the impact of permissiveness toward tobacco sponsorship activities on support for tobacco control policies (p < 0.05). The median of prevalence of support for different tobacco control policies among all countries was as follows: complete ban on tobacco advertisements (84.9%); comprehensive smoke-free laws (92.4%) and tobacco price increases (80.8%). School personnel who believed that the tobacco industry should be allowed to sponsor school events were significantly less likely to support complete bans on tobacco advertisements [aPR = 0.89; 95% confidence interval (CI) 0.84-0.95] and comprehensive smoke-free laws (aPR = 0.95; 95% CI 0.92-0.98). In contrast, support for complete tobacco advertisement bans was more likely among those who believed that the tobacco industry encourages youths to smoke (aPR = 1.27; 95% CI 1.17-1.37), and among those who taught about health sometimes (aPR = 1.06; 95% CI 1.01-1.11) or a lot (aPR = 1.05; 95% CI 1.01-1.10) compared with those who did not teach about health at all. These findings underscore the need to educate school personnel on tobacco industry's strategies to undermine tobacco control policies. This may help to build school personnel support for laws intended to reduce youth susceptibility, experimentation and established use of tobacco products. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Does right lateral decubitus position change retroperitoneal oblique corridor? A radiographic evaluation from L1 to L5.

    PubMed

    Zhang, Fan; Xu, Haocheng; Yin, Bo; Tao, Hongyue; Yang, Shuo; Sun, Chi; Wang, Yitao; Yin, Jun; Shao, Minghao; Wang, Hongli; Xia, Xinlei; Ma, Xiaosheng; Lu, Feizhou; Jiang, Jianyuan

    2017-03-01

    To determine if the retroperitoneal oblique corridor will be affected by right lateral decubitus position. Forty volunteers were randomly enrolled and MRI scan was performed from L1 to L5 in supine and right lateral decubitus positions, respectively. In images across the center of each disc, O was defined as the center of a disc and A (supine) or A' (right lateral decubitus) was located in left lateral border of the aorta or the iliac artery; B (supine) or B' (right lateral decubitus) was on the anterior medial border of the psoas. The distance of AB and A'B' (Recorded as A-Ps and A-Pr, respectively) at each level was recorded and compared to each other. The relationships between A-Pr, sex, BMI and relative psoas cross-sectional area (PCSA) at each level were also evaluated. A-Pr was significantly smaller than A-Ps at L1/2, L2/3 and L3/4 (All p < 0.05); there was no significantly difference of A-Pr between all levels (p = 0.105), but L1/2 seemed to be larger than L3/4, followed by L2/3 and L4/5; A-Pr at each level was not affected by sex (All p > 0.05); linear relationships were found between A-Pr, BMI and PCSA at L1/2 and L3/4. ROC at L1/2, L2/3 and L3/4 will significantly decrease from supine to right lateral decubitus position and the reason may be due to the relaxed psoas deformation. Using MRI images in supine position for pre-operatively ROC evaluation is not accurate. Spine surgeon should also be more cautious when OLIF is performed at L4/5 where ROC is the smallest. Patients from Asia and those with strong psoas major at L1/2 and L3/4 are also associated with relatively narrow ROC.

  11. Parental Communication, Engagement, and Support During the Adolescent Voluntary Medical Male Circumcision Experience.

    PubMed

    Dam, Kim H; Kaufman, Michelle R; Patel, Eshan U; Van Lith, Lynn M; Hatzold, Karin; Marcell, Arik V; Mavhu, Webster; Kahabuka, Catherine; Mahlasela, Lusanda; Njeuhmeli, Emmanuel; Seifert Ahanda, Kim; Ncube, Getrude; Lija, Gissenge; Bonnecwe, Collen; Tobian, Aaron A R

    2018-04-03

    Voluntary medical male circumcision (VMMC) is one of few opportunities in sub-Saharan Africa to engage male adolescents in the healthcare system. Limited data are available on the level of parental communication, engagement, and support adolescents receive during the VMMC experience. We conducted 24 focus group discussions with parents/guardians of adolescents (N = 192) who agreed to be circumcised or were recently circumcised in South Africa, Tanzania, and Zimbabwe. In addition, male adolescents (N = 1293) in South Africa (n = 299), Tanzania (n = 498), and Zimbabwe (n = 496) were interviewed about their VMMC experience within 7-10 days postprocedure. We estimated adjusted prevalence ratios (aPRs) using multivariable Poisson regression with generalized estimating equations and robust standard errors. Parents/guardians noted challenges and gaps in communicating with their sons about VMMC, especially when they did not accompany them to the clinic. Adolescents aged 10-14 years were significantly more likely than 15- to 19-year-olds to report that their parent accompanied them to a preprocedure counseling session (56.5% vs 12.5%; P < .001). Among adolescents, younger age (aPR, 0.86; 95% confidence interval [CI], .76-.99) and rural setting (aPR, 0.34; 95% CI, .13-.89) were less likely to be associated with parental-adolescent communication barriers, while lower socioeconomic status (aPR, 1.37; 95% CI, 1.00-1.87), being agnostic (or of a nondominant religion; aPR, 2.87; 95% CI, 2.21-3.72), and living in South Africa (aPR, 2.63; 95% CI, 1.29-4.73) were associated with greater perceived barriers to parental-adolescent communication about VMMC. Parents/guardians found it more difficult to be involved in wound care for older adolescents than for adolescents <15 years of age. Parents play a vital role in the VMMC experience, especially for younger male adolescents. Strategies are needed to inform parents completely throughout the VMMC adolescent experience, whether or not

  12. Determinants of Heterosexual Adolescents Having Sex with Female Sex Workers in Singapore

    PubMed Central

    Ng, Junice Y. S.; Wong, Mee-Lian

    2016-01-01

    Objectives We assessed the proportion of and socio-ecological factors associated with ever having had sex with female sex workers (FSWs) among heterosexual adolescents. We also described the characteristics of the adolescents who reported inconsistent condom use with FSWs. Methods This is a cross-sectional study (response rate: 73%) of 300 heterosexually active male adolescents of 16 to 19 years attending a national STI clinic in Singapore between 2009 and 2014. We assessed the ecological factors (individual, parental, peer, school and medial influences) and sexual risk behaviors using a self-reported questionnaire. Poisson regression was used to obtain the adjusted prevalence ratios (aPR) and confidence intervals (CI). Results The proportion of heterosexual male adolescents who had ever had sex with FSWs was 39%. Multivariate analysis showed that significant factors associated with ever having had sex with FSWs were sex initiation before 16 years old (aPR 1.79 CI: 1.30–2.46), never had a sexually active girlfriend (aPR 1.75 CI 1.28–2.38), reported lower self-esteem score (aPR 0.96 CI: 0.93–0.98), higher rebelliousness score (aPR 1.03 CI: 1.00–1.07) and more frequent viewing of pornography (aPR 1.47 CI: 1.04–2.09). Lifetime inconsistent condom use with FSWs was 30%. Conclusions A significant proportion of heterosexual male adolescents attending the public STI clinic had ever had sex with FSWs. A targeted intervention that addresses different levels of influence to this behavior is needed. This is even more so because a considerable proportion of adolescents reported inconsistent condom use with FSWs, who may serve as a bridge of STI transmission to the community. National surveys on adolescent health should include the assessment of frequency of commercial sex visits and condom use with FSWs for long-term monitoring and surveillance. PMID:26808561

  13. Parental Communication, Engagement, and Support During the Adolescent Voluntary Medical Male Circumcision Experience

    PubMed Central

    Dam, Kim H; Kaufman, Michelle R; Patel, Eshan U; Van Lith, Lynn M; Hatzold, Karin; Marcell, Arik V; Mavhu, Webster; Kahabuka, Catherine; Mahlasela, Lusanda; Njeuhmeli, Emmanuel; Seifert Ahanda, Kim; Ncube, Getrude; Lija, Gissenge; Bonnecwe, Collen; Tobian, Aaron A R

    2018-01-01

    Abstract Background Voluntary medical male circumcision (VMMC) is one of few opportunities in sub-Saharan Africa to engage male adolescents in the healthcare system. Limited data are available on the level of parental communication, engagement, and support adolescents receive during the VMMC experience. Methods We conducted 24 focus group discussions with parents/guardians of adolescents (N = 192) who agreed to be circumcised or were recently circumcised in South Africa, Tanzania, and Zimbabwe. In addition, male adolescents (N = 1293) in South Africa (n = 299), Tanzania (n = 498), and Zimbabwe (n = 496) were interviewed about their VMMC experience within 7–10 days postprocedure. We estimated adjusted prevalence ratios (aPRs) using multivariable Poisson regression with generalized estimating equations and robust standard errors. Results Parents/guardians noted challenges and gaps in communicating with their sons about VMMC, especially when they did not accompany them to the clinic. Adolescents aged 10–14 years were significantly more likely than 15- to 19-year-olds to report that their parent accompanied them to a preprocedure counseling session (56.5% vs 12.5%; P < .001). Among adolescents, younger age (aPR, 0.86; 95% confidence interval [CI], .76–.99) and rural setting (aPR, 0.34; 95% CI, .13–.89) were less likely to be associated with parental–adolescent communication barriers, while lower socioeconomic status (aPR, 1.37; 95% CI, 1.00–1.87), being agnostic (or of a nondominant religion; aPR, 2.87; 95% CI, 2.21–3.72), and living in South Africa (aPR, 2.63; 95% CI, 1.29–4.73) were associated with greater perceived barriers to parental–adolescent communication about VMMC. Parents/guardians found it more difficult to be involved in wound care for older adolescents than for adolescents <15 years of age. Conclusions Parents play a vital role in the VMMC experience, especially for younger male adolescents. Strategies are needed to inform parents

  14. Randomized controlled multicentre study comparing biological mesh closure of the pelvic floor with primary perineal wound closure after extralevator abdominoperineal resection for rectal cancer (BIOPEX-study)

    PubMed Central

    2014-01-01

    Background Primary perineal wound closure after conventional abdominoperineal resection (cAPR) for rectal cancer has been the standard of care for many years. Since the introduction of neo-adjuvant radiotherapy and the extralevator APR (eAPR), oncological outcome has been improved, but at the cost of increased rates of perineal wound healing problems and perineal hernia. This has progressively increased the use of biological meshes, although not supported by sufficient evidence. The aim of this study is to determine the effectiveness of pelvic floor reconstruction using a biological mesh after standardized eAPR with neo-adjuvant (chemo)radiotherapy compared to primary perineal wound closure. Methods/Design In this multicentre randomized controlled trial, patients with a clinical diagnosis of primary rectal cancer who are scheduled for eAPR after neo-adjuvant (chemo)radiotherapy will be considered eligible. Exclusion criteria are prior radiotherapy, sacral resection above S4/S5, allergy to pig products or polysorbate, collagen disorders, and severe systemic diseases affecting wound healing, except for diabetes. After informed consent, 104 patients will be randomized between standard care using primary wound closure of the perineum and the experimental arm consisting of suturing a biological mesh derived from porcine dermis in the pelvic floor defect, followed by perineal closure similar to the control arm. Patients will be followed for one year after the intervention and outcome assessors and patients will be blinded for the study treatment. The primary endpoint is the percentage of uncomplicated perineal wound healing, defined as a Southampton wound score of less than II on day 30. Secondary endpoints are hospital stay, incidence of perineal hernia, quality of life, and costs. Discussion The BIOPEX-study is the first randomized controlled multicentre study to determine the additive value of using a biological mesh for perineal wound closure after eAPR with neo

  15. Associations between excessive adiposity and seroprevalence of herpes simplex virus type 1 and type 2 among US adults: a population-based age-period-cohort analysis.

    PubMed

    Liu, Su-Hsun; Tzeng, I-Shiang; Hsieh, Tsung-Han; Huang, Yhu-Chering

    2016-10-17

    Evidence on the association between herpes simplex virus (HSV) and excessive adiposity, such as obesity (body mass index ≥30 kg/m 2 ) and abdominal obesity (waist circumference (WC) >102 or 88 cm), has been inconsistent. We sought to examine whether age-period-cohort (APC) effects could explain for the observed heterogeneities. Population-based cross-sectional study. Adults aged 20-49 years with available serological data in the National Health and Nutrition Examination Survey (NHANES) in 1999-2012. Obesity and abdominal obesity. In men, excessive adiposity was generally not associated with HSV1 or HSV2 (all p>0.05); however, there were positive correlations between HSV seroprevalence and excessive adiposity in certain age and birth cohort groups. Based on APC analysis, abdominally obese men aged 30-40 years showed a nearly 20% increase in risk for HSV1 seropositivity (adjusted prevalence ratio (aPR)=1.18; 95% CI 1.10 to 1.27) as compared with abdominally non-obese men of the same age; there was no such association in men of other age groups. Also, men of a large WC who were born before 1962 or after 1979 had a 28% higher risk for HSV2 seropositivity than those of a normal WC in the same birth cohorts (aPR=1.28, 95% CI 1.17 to 1.54); yet the association did not hold for men in other cohorts (aPR=0.86, 95% CI 0.64 to 1.17). In women, a large WC was correlated with a minimally increased HSV1 seroprevalence (aPR=1.07, 95% CI 1.01 to 1.13) but not with HSV2 seropositivity (aPR=1.13; 95% CI 0.99 to 1.28). Likewise, there were strong associations between abdominal obesity and HSV2 seropositivity in subgroups of women participating in the earliest survey cycle (aPR=1.41, 95% CI 1.12 to 1.78) but not in other survey periods (aPR=0.94, 95% CI 0.85 to 1.03). There was no consistent evidence for strong associations between HSV seropositivity and excessive adiposity in adults. APC analysis results further cautioned the generalisability of previous reports based on 1

  16. Associations between excessive adiposity and seroprevalence of herpes simplex virus type 1 and type 2 among US adults: a population-based age–period–cohort analysis

    PubMed Central

    Tzeng, I-Shiang; Hsieh, Tsung-Han; Huang, Yhu-Chering

    2016-01-01

    Objectives Evidence on the association between herpes simplex virus (HSV) and excessive adiposity, such as obesity (body mass index ≥30 kg/m2) and abdominal obesity (waist circumference (WC) >102 or 88 cm), has been inconsistent. We sought to examine whether age–period–cohort (APC) effects could explain for the observed heterogeneities. Design Population-based cross-sectional study. Participants Adults aged 20–49 years with available serological data in the National Health and Nutrition Examination Survey (NHANES) in 1999–2012. Exposure measures Obesity and abdominal obesity. Results In men, excessive adiposity was generally not associated with HSV1 or HSV2 (all p>0.05); however, there were positive correlations between HSV seroprevalence and excessive adiposity in certain age and birth cohort groups. Based on APC analysis, abdominally obese men aged 30–40 years showed a nearly 20% increase in risk for HSV1 seropositivity (adjusted prevalence ratio (aPR)=1.18; 95% CI 1.10 to 1.27) as compared with abdominally non-obese men of the same age; there was no such association in men of other age groups. Also, men of a large WC who were born before 1962 or after 1979 had a 28% higher risk for HSV2 seropositivity than those of a normal WC in the same birth cohorts (aPR=1.28, 95% CI 1.17 to 1.54); yet the association did not hold for men in other cohorts (aPR=0.86, 95% CI 0.64 to 1.17). In women, a large WC was correlated with a minimally increased HSV1 seroprevalence (aPR=1.07, 95% CI 1.01 to 1.13) but not with HSV2 seropositivity (aPR=1.13; 95% CI 0.99 to 1.28). Likewise, there were strong associations between abdominal obesity and HSV2 seropositivity in subgroups of women participating in the earliest survey cycle (aPR=1.41, 95% CI 1.12 to 1.78) but not in other survey periods (aPR=0.94, 95% CI 0.85 to 1.03). Conclusions There was no consistent evidence for strong associations between HSV seropositivity and excessive adiposity in adults. APC analysis

  17. Life Cycle Sustainment of Commercial Off-the-Shelf (COTS) Support Equipment

    DTIC Science & Technology

    2012-05-01

    CO E WS50AA 1 N9C422319 BHL10326 UC09AQ Jun-10 AR HOUSTON TX 808 VERTICAL CONST CO E WS50AA 1 N9C422321 BHL10328 UC09AS Jun-10 AR HILO HI 871...VERTICAL CONST CO E WQX8AA 1 N9C422528 BHL10535 UC09RP 23-Apr-10 AR HILO HI 871 VERTICAL CONST CO E WQX8AA 1 N9C422534 BHL10541 UC09RV 23-Apr-10 AR... HILO HI 871 VERTICAL CONST CO E WQX8AA 1 N9C422561 BHL10568 UC09SN 23-Apr-10 AR FT LEONARD WOOD MO 955 HORIZONTAL CONST CO E WRZUAA 1 N9C422375

  18. Worldwide Report, Epidemiology, No. 321.

    DTIC Science & Technology

    1983-06-06

    Africa To order, see inside front cover JPRS 83616 6 June 1983 WORLDWIDE REPORT EPIDEMIOLOGY No« 321 CONTENTS HUMAN DISEASES BELIZE Briefs...Reported (SPK, k May 83) 10 MALAYSIA Sabah. Cholera Deaths Reported (THE NATIONAL ECHO, 30 Apr 83) H Sarawak Reviews Anti- Dengue ...Outbreak (CAMEROON TRIBUNE, 27 Apr 83) ^3 ISRAEL Briefs identification, Control of Corn ■yirus- kk - d - BELIZE BRIEFS RISE IN MALARIA— Belize is

  19. Technologies for Hemostasis and Stabilization of the Acute Traumatic Wound

    DTIC Science & Technology

    2014-10-01

    Thomas D. Morris Institute TEG thromboelastography UMM University of Maryland Medical Center UNL University of Nebraska—Lincoln UNMC University of...two subjects, and see what happens. VII. PLAN On the next three consecutive Tuesdays (Mar 25, Apr 1, Apr 8), we will be...Stabilization of the Acute Traumatic Wound" Jessica, Drs. Velander, Larsen, and I have decided to cancel our subcontract with the Thomas D. Morris Institute

  20. JPRS Report, Science & Technology, USSR: Electronics & Electrical Engineering.

    DTIC Science & Technology

    1988-12-14

    of Angle Measurement on Orientation of Porro Prism in Interferometer [G. A. Lenkova; AVTOMETRIYA, No 2, Mar-Apr 88] 33 Laser-Doppler Anemometer With...Measurement on Orientation of Porro Prism in Interferometer 18600122e Novosibirsk A VTOMETRIYA in Russian No 2, Mar-Apr 88 (manuscript received 19...identical Porro prisms being mounted rigidly on a common support and sym- metrically with respect to the axis of rotation. The range of measurable

  1. East Europe Report: Political, Sociological and Military Affairs. No. 2149

    DTIC Science & Technology

    1983-06-07

    incluence social life in the framework of the movement’s program. H. Swierczewski from Krasocin gave high marks to the declaration and bylaws drafts...83) .. BULGARIA Media Presentation of Karamanlis Speech in Bulgaria (RABOTNICHESKO DELO, 26 Apr 83) 3 Greek President Karamanlis Delivers...HANDELSBLAD, 30 Apr 83) 19 Deterioration in Social Climate, by Peter Michielsen Charter 77’s Kyncl on Situation, Karel Kyncl Interview Writer Bohumil

  2. Aerial Observation; A Bibliography of Periodical Articles.

    DTIC Science & Technology

    1982-04-01

    99,90, Jan 1944. ’If not an Air OP why not locatinc7," 2CRA, ?0:115-123, Apr 1953. Jackson , I-ian E. "FDC an- the Artillery Air Observer," FM, 34...194, 1886. Thom.pson, Percy N;. "Organization and ’aneuver of Ficld Artillery Observation," .*IL RVW, 25:53-60, Apr 1945. "To See or not to see," JORA

  3. Near East/South Asia Report, No. 2777

    DTIC Science & Technology

    1983-07-01

    Appointments 14 Canal Income 14 ARAB EAST/ISRAEL ISRAEL Stepped-Up Settlement Building Worries Palestinians on West Bank ..’ (AL-BAYADIR AL-SIYASI, 16...34 Apr 83l ... ....................... ....15 West Bank Chambers of Commerce Discuss Local Issues "’." (AEAMIR’AHY.27 Apr .83...approved bank and with the Algerian National Savings and Insurance Bank (CNEP). In this case he will have the following advantages: he will receive the

  4. USSR Report, Chemistry

    DTIC Science & Technology

    1985-08-16

    of the thermal interaction of polonium - 210 with palladium and iridium. The vacuum-thermal method of direct synthesis was used, a study of the...ZHURNAL -PRIKLADNOY KHIMII, No k, Apr 85) Ik CATALYSIS Effect of Intermetallic Compounds Zr-Co Composition on Their Catalytic Properties in...KHIMICHESKAYA, No U, Apr 85) IT Effect of Stabilization on Adsorption and Catalytic Properties of Electrodeposited Platinum Catalysts (T. M. Grishina, Ye. V

  5. Cardiovascular Profile of Valbenazine: Analysis of Pooled Data from Three Randomized, Double-Blind, Placebo-Controlled Trials.

    PubMed

    Thai-Cuarto, Dao; O'Brien, Christopher F; Jimenez, Roland; Liang, Grace S; Burke, Joshua

    2018-04-01

    Valbenazine is a novel vesicular monoamine transporter 2 inhibitor approved for the treatment of tardive dyskinesia in adults. Using data from double-blind, placebo-controlled trials, analyses were conducted to evaluate the cardiovascular effects of once-daily valbenazine in patients with a psychiatric disorder who developed tardive dyskinesia after exposure to a dopamine-blocking medication. Data were pooled from three 6-week, double-blind, placebo-controlled trials: KINECT (NCT01688037), KINECT 2 (NCT01733121), and KINECT 3 (NCT02274558). Data from the 42-week valbenazine extension period of KINECT 3 were also analyzed. Outcomes of interest included cardiovascular-related treatment-emergent adverse events, vital sign measurements, and electrocardiogram parameters. The pooled safety population included 400 participants (placebo, n = 178; valbenazine 40 mg/day, n = 110; valbenazine 80 mg/day, n = 112). A history of cardiac disorders was present in 11.8% of participants, and 74.3% were taking a concomitant medication with known potential for QT prolongation. Mean changes from baseline to week 6 in supine vital signs and QTcF (Fridericia correction) were as follows for placebo, valbenazine 40 mg/day, and valbenazine 80 mg/day, respectively: systolic blood pressure (0.2, - 2.1, - 1.8 mmHg), diastolic blood pressure (- 0.1, - 1.6, - 1.2 mmHg), heart rate (- 1.7, - 2.2, - 1.7 bpm), QTcF interval (1.2, 1.1, 2.1 ms); all p > 0.05 for valbenazine vs. placebo. No statistically significant differences were observed between placebo and valbenazine in cardiovascular-related, treatment-emergent adverse events. No notable additional effects on cardiovascular outcomes were found with up to 48 weeks of valbenazine treatment. Results from double-blind, placebo-controlled trials showed no apparent difference between valbenazine and placebo on cardiovascular outcomes. No additional cardiovascular risk was detected during a longer extension study with

  6. Psychotic states arising in late life (late paraphrenia). The role of risk factors.

    PubMed

    Almeida, O P; Howard, R J; Levy, R; David, A S

    1995-02-01

    This study explored the association between 'late paraphrenia' and various risk factors such as female gender, sensory impairment, marital status, positive family history of psychoses, and the presence of abnormal neurological signs. It was hypothesised that patients would show significantly more abnormal neurological signs than controls. Inclusion criteria for the diagnosis of late paraphrenia were fulfilled by 47 patients, including in-patients, out-patients, day-patients, and those living in the community. Thirty-three age-, sex-, education-, and premorbid IQ-matched elderly controls were recruited from luncheon clubs in Southwark and Lambeth (London, UK). A scale for the assessment of neurological soft and hard signs was developed for this study. The Abnormal Involuntary Movement Scale (AIMS) and the Tardive Dyskinesia Rating Scale (TDRS) were also used. There was a high female-to-male ratio (42:5), and a fourfold increase in the risk of patients having hearing impairment (odds ratio = 4.15, Clodds = 1.36 to 12.63). There was no difference between the two groups in visual difficulties nor in marital status. Patients were approximately ten times more likely to be living on their own (odds ratio = 10.61; Clodds = 3.59 to 31.33) and 16 times more likely to be considered socially isolated (odds ratio = 16.65; Clodds = 5.39 to 51.40). There was no difference between patients and controls in frequency of schizophrenia-like family history. Patients were more likely than controls to exhibit neurological soft signs (z = 4.70; P < 0.001; Cld = 4.61 to 9.63). The presence of abnormal involuntary and tardive dyskinesia movements was associated with the use of antipsychotic medication. Women appear to run a greater risk of developing late paraphrenia, especially those who are socially isolated and present with associated hearing impairment. The increased presence of neurological soft signs among patients indicates that brain disease may be a critical factor in the

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

    Brown, Kyle E.; Division of Gastroenterology-Hepatology, University of Iowa Roy J. and Lucille A. Carver College of Medicine; Program in Free Radical and Radiation Biology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA

    Introduction:: Oxidative stress can trigger a cellular stress response characterized by induction of antioxidants, acute phase reactants (APRs) and heat shock proteins (HSPs), which are presumed to play a role in limiting tissue damage. In rodents, hepatic iron overload causes oxidative stress that results in upregulation of antioxidant defenses with minimal progressive liver injury. The aim of this study was to determine whether iron overload modulates expression of other stress-responsive proteins such as APRs and HSPs that may confer protection against iron-induced damage in rodent liver. Methods:: Male rats received repeated injections of iron dextran or dextran alone over amore » 6-month period. Hepatic transcript levels for a panel of APRs and HSPs were quantitated by real-time PCR and protein expression was evaluated by Western blot and immunohistochemistry. Results:: Hepatic iron concentrations were increased > 50-fold in the iron-loaded rats compared to controls. Iron loading resulted in striking increases in mRNAs for Hsp32 (heme oxygenase-1; 12-fold increase vs. controls) and metallothionein-1 and -2 (both increased {approx} 6-fold). Transcripts for {alpha}1-acid glycoprotein, the major rat APR, were increased {approx} 3-fold, while expression of other classical APRs was unaltered. Surprisingly, although mRNA levels for the HSPs were not altered by iron, the abundance of Hsp25, Hsp70 and Hsp90 proteins was uniformly reduced in the iron-loaded livers, as were levels of NAD(P)H:quinone oxidoreductase 1, an Hsp70 client protein. Conclusions:: Chronic iron administration elicits a unique pattern of stress protein expression. These alterations may modulate hepatic responses to iron overload, as well as other injury processes.« less

  8. QTL mapping of slow-rusting, adult plant resistance to race Ug99 of stem rust fungus in PBW343/Muu RIL population.

    PubMed

    Singh, Sukhwinder; Singh, Ravi P; Bhavani, Sridhar; Huerta-Espino, Julio; Eugenio, Lopez-Vera Eric

    2013-05-01

    Races of stem rust fungus pose a major threat to wheat production worldwide. We mapped adult plant resistance (APR) to Ug99 in 141 lines of a PBW343/Muu recombinant inbred lines (RILs) population by phenotyping them for three seasons at Njoro, Kenya in field trials and genotyping them with Diversity Arrays Technology (DArT) markers. Moderately susceptible parent PBW343 and APR parent Muu displayed mean stem rust severities of 66.6 and 5 %, respectively. The mean disease severity of RILs ranged from 1 to 100 %, with an average of 23.3 %. Variance components for stem rust severity were highly significant (p < 0.001) for RILs and seasons and the heritability (h (2)) for the disease ranged between 0.78 and 0.89. Quantitative trait loci (QTL) analysis identified four consistent genomic regions on chromosomes 2BS, 3BS, 5BL, and 7AS; three contributed by Muu (QSr.cim-2BS, QSr.cim-3BS and QSr.cim-7AS) and one (QSr.cim-5BL) derived from PBW343. RILs with flanking markers for these QTLs had significantly lower severities than those lacking the markers, and combinations of QTLs had an additive effect, significantly enhancing APR. The QTL identified on chromosome 3BS mapped to the matching region as the known APR gene Sr2. Four additional QTLs on chromosomes 1D, 3A, 4B, and 6A reduced disease severity significantly at least once in three seasons. Our results show a complex nature of APR to stem rust where Sr2 and other minor slow rusting resistance genes can confer a higher level of resistance when present together.

  9. Predicting High-Power Performance in Professional Cyclists.

    PubMed

    Sanders, Dajo; Heijboer, Mathieu; Akubat, Ibrahim; Meijer, Kenneth; Hesselink, Matthijs K

    2017-03-01

    To assess if short-duration (5 to ~300 s) high-power performance can accurately be predicted using the anaerobic power reserve (APR) model in professional cyclists. Data from 4 professional cyclists from a World Tour cycling team were used. Using the maximal aerobic power, sprint peak power output, and an exponential constant describing the decrement in power over time, a power-duration relationship was established for each participant. To test the predictive accuracy of the model, several all-out field trials of different durations were performed by each cyclist. The power output achieved during the all-out trials was compared with the predicted power output by the APR model. The power output predicted by the model showed very large to nearly perfect correlations to the actual power output obtained during the all-out trials for each cyclist (r = .88 ± .21, .92 ± .17, .95 ± .13, and .97 ± .09). Power output during the all-out trials remained within an average of 6.6% (53 W) of the predicted power output by the model. This preliminary pilot study presents 4 case studies on the applicability of the APR model in professional cyclists using a field-based approach. The decrement in all-out performance during high-intensity exercise seems to conform to a general relationship with a single exponential-decay model describing the decrement in power vs increasing duration. These results are in line with previous studies using the APR model to predict performance during brief all-out trials. Future research should evaluate the APR model with a larger sample size of elite cyclists.

  10. Interaction of Sulfate Assimilation with Carbon and Nitrogen Metabolism in Lemna minor1

    PubMed Central

    Kopriva, Stanislav; Suter, Marianne; von Ballmoos, Peter; Hesse, Holger; Krähenbühl, Urs; Rennenberg, Heinz; Brunold, Christian

    2002-01-01

    Cysteine synthesis from sulfide and O-acetyl-l-serine (OAS) is a reaction interconnecting sulfate, nitrogen, and carbon assimilation. Using Lemna minor, we analyzed the effects of omission of CO2 from the atmosphere and simultaneous application of alternative carbon sources on adenosine 5′-phosphosulfate reductase (APR) and nitrate reductase (NR), the key enzymes of sulfate and nitrate assimilation, respectively. Incubation in air without CO2 led to severe decrease in APR and NR activities and mRNA levels, but ribulose-1,5-bisphosphate carboxylase/oxygenase was not considerably affected. Simultaneous addition of sucrose (Suc) prevented the reduction in enzyme activities, but not in mRNA levels. OAS, a known regulator of sulfate assimilation, could also attenuate the effect of missing CO2 on APR, but did not affect NR. When the plants were subjected to normal air after a 24-h pretreatment in air without CO2, APR and NR activities and mRNA levels recovered within the next 24 h. The addition of Suc and glucose in air without CO2 also recovered both enzyme activities, with OAS again influenced only APR. 35SO42− feeding showed that treatment in air without CO2 severely inhibited sulfate uptake and the flux through sulfate assimilation. After a resupply of normal air or the addition of Suc, incorporation of 35S into proteins and glutathione greatly increased. OAS treatment resulted in high labeling of cysteine; the incorporation of 35S in proteins and glutathione was much less increased compared with treatment with normal air or Suc. These results corroborate the tight interconnection of sulfate, nitrate, and carbon assimilation. PMID:12428005

  11. HOSPITAL VARIATION IN SPHINCTER PRESERVATION FOR ELDERLY RECTAL CANCER PATIENTS

    PubMed Central

    Dodgion, Christopher M.; Neville, Bridget A; Lipsitz, Stuart R.; Schrag, Deborah; Breen, Elizabeth; Zinner, Michael J.; Greenberg, Caprice C.

    2014-01-01

    Purpose To evaluate hospital variation in the use of low anterior resection (LAR), local excision (LE) and abdominoperineal resection (APR) in the treatment of rectal cancer in elderly patients. Methods Using SEER-Medicare linked data, we identified 4,959 stage I–III rectal cancer patients over age 65 diagnosed from 2000–2005 who underwent operative intervention at one of 370 hospitals. We evaluated the distribution of hospital-specific procedure rates and used generalized mixed models with random hospital effects to examine the influence of patient characteristics and hospital on operation type, using APR as a reference. Results The median hospital performed APR on 33% of elderly rectal cancer patients. Hospital was a stronger predictor of LAR receipt than any patient characteristic, explaining 32% of procedure choice, but not a strong predictor of LE, explaining only 3.8%. Receipt of LE was primarily related to tumor size and tumor stage, which, combined, explained 31% of procedure variation. Conclusions Receipt of local excision is primarily determined by patient characteristics. In contrast, the hospital where surgery is performed significantly influences whether a patient undergoes an LAR or APR. Understanding the factors that cause this institutional variation is crucial to ensuring equitable availability of sphincter preservation. PMID:24750983

  12. Stability and function of a putative microtubule-organizing center in the human parasite Toxoplasma gondii

    PubMed Central

    Leung, Jacqueline M.; He, Yudou; Zhang, Fangliang; Hwang, Yu-Chen; Nagayasu, Eiji; Liu, Jun; Murray, John M.; Hu, Ke

    2017-01-01

    The organization of the microtubule cytoskeleton is dictated by microtubule nucleators or organizing centers. Toxoplasma gondii, an important human parasite, has an array of 22 regularly spaced cortical microtubules stemming from a hypothesized organizing center, the apical polar ring. Here we examine the functions of the apical polar ring by characterizing two of its components, KinesinA and APR1, and show that its putative role in templating can be separated from its mechanical stability. Parasites that lack both KinesinA and APR1 (ΔkinesinAΔapr1) are capable of generating 22 cortical microtubules. However, the apical polar ring is fragmented in live ΔkinesinAΔapr1 parasites and is undetectable by electron microscopy after detergent extraction. Disintegration of the apical polar ring results in the detachment of groups of microtubules from the apical end of the parasite. These structural defects are linked to a diminished ability of the parasite to move and invade host cells, as well as decreased secretion of effectors important for these processes. Together the findings demonstrate the importance of the structural integrity of the apical polar ring and the microtubule array in the Toxoplasma lytic cycle, which is responsible for massive tissue destruction in acute toxoplasmosis. PMID:28331073

  13. Rocky Mountain Arsenal North Boundary Treatment Facility: Chemical Data, 1985. Volume 2

    DTIC Science & Technology

    1986-04-01

    SEP OCT NOV DEC 86 SAMPLE DATE (YEAR AND MONTH) SITE PNDW35 FOR ISODR 0.7i 0.8 0.7 0.6-1 2 • 0.5 -~ 0,2 0.2 06 II AI DAT IyA. AND ! I SJ F .MAR APR MAY...MONTH) SITE PNDW43 FOR CPMSO so- 40 . 38 30 0 25 ai a a U I I I I I I I U 5 JAN FM MAR APR MAY JiN JL AUG SEP OCT NOV DEC WB SAMPLE DATE ClEAR AND MONTH...I I I I 5 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC S SAMPLE DATE tfEAR AND MONTN) SITE PNDW54 FOR DLDRN 0.7a.6 0.4 0.3 0.2 " AI 0 0 0 I I I I I

  14. JPRS Report, Science & Technology, USSR: Materials Science

    DTIC Science & Technology

    1988-07-11

    MATERIALY, No 2, Mar-Apr 88) , 19 Formation of Multilayer Polytypes Based on Diamond or Sphaleritic Boron Nitride Under High Pressures at High...in Compact Modifications of Boron Nitride (V. B, Shipilo, et al,; SVERKHTVERDYYE MATERIALY, No 2, Mar-Apr 88) 20 Change in Electrical...25CrMnNiMoTi alloy steel were first refined by heat treatment and then, covered with a heat-absorbent MnP04 coating , treated with a laser beam

  15. JPRS Report. Science & Technology, USSR: Engineering & Equipment.

    DTIC Science & Technology

    1988-12-19

    unlimited Science & Technology USSR: Engineering & Equipment ^PRODUCED BY ^J’ODNALTECSL OF AMERCE SPR/NGnEL^ff’^1-INFORMATION S 22161 SERVICE...rv> DTIC QUALITY mSHBOTSD j5 Science & Technology USSR: Engineering & Equipment JPRS-UEQ-88-006 CONTENTS 19 DECEMBER 1988 Nuclear Energy Fuel...PROMYSHLENNOST, No 4, Apr 88] 36 Determining the Demand for Automated Foundry Equipment [A.A. Panov; MEKHAN1ZATS1YA IAVTOMATIZATSIYA PROIZVODSTVA, Apr 88] 40

  16. Latin America Report No. 2672.

    DTIC Science & Technology

    1983-04-28

    Studied by Venezuela (CANA, 10 Apr 83) 57 - b - Timber Sale Contract Signed With PRC (CANA, 10 Apr 83) 58 Briefs New French Envoy 59...distinguish two epochs here. In this entire stage of growth of Peronist activity—which was massive in some cases like the Cordobazo where there were...Answer] These were side groups which—as in the case of Tacuara and the Na- tionalist Restoration Guard—were generally tied to the intelligence services

  17. JPRS Report, Arms Control

    DTIC Science & Technology

    1989-04-12

    14 LATIN AMERICA ARGENTINA Condor II Missile Project With Egypt Reportedly Cancelled 16 Israeli Pressure Alleged [NOTIC1AS ARGENT1NAS 4 Apr] 16...this issue, [passage omitted] JPRS-TAC-89-015 12 April 1989 LATIN AMERICA 16 ARGENTINA Condor II Missile Project With Egypt Reportedly Cancelled...Aires NOTICIAS ARGENTINAS in Spanish 1405 GMT 4 Apr 89 The technology for flight orientation and guidance has reportedly been provided by FRG and

  18. Ada (Trade Name) Compiler Validation Summary Report. Harris Corporation, HARRIS Ada Compiler, Version 1.0, Harris H1200 and H800.

    DTIC Science & Technology

    1987-04-30

    AiBI 895 ADA (TRADENNANE) COMPILER VALIDATION SUMMARY REPORT / HARRIS CORPORATION HA (U) INFORMATION SYSTEMS AND TECHNOLOGY CENTER W-P AFS OH ADA...Compiler Validation Summary Report : 30 APR 1986 to 30 APR 1987 Harris Corporation, HARRIS Ada Compiler, Version 1.0, Harris H1200 and H800 6...the United States Government (Ada Joint Program Office). Adae Compiler Validation mary Report : Compiler Name: HARRIS Ada Compiler, Version 1.0 1 Host

  19. Translations on People’s Republic of China, Number 390

    DTIC Science & Technology

    1977-08-15

    certain eye diseases, treatment which is carried out for more than 20 diseases. In recent years, the scope of laser use in medicine is gradually...PAO, 1 Apr 77) 18 Treatment of Carcinoma Being Studied, Improved (TA KUNG PAO, 6 Apr 77) 21 Medical Instrument Industry Increases Production...before our eyes one by one Our people’s broadcasting enterprise was founded and developed under the leadership and personal care of our great leader

  20. Southeast Asia Report.

    DTIC Science & Technology

    1987-05-20

    Vigilantism (Ninez Cacho-Olivares; BUSINESS DAY, 2 Apr 87) 29 - b ’Fanatical1 Anticommünist Group Initiation (THE MANILA TIMES, 3 Apr 87) J ...typical American pro- blem: the absence of effective law and order in a frontier re- gion," says Richard Maxwell Brown in an official report for the... j household wares, toys, ’ chinaware, tobacco, ply- wood, electronic, micro- circuits, tennis balls and acrylic yarn. Bananas are seen to have