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Complex Condition (complex + condition)

Distribution by Scientific Domains

Medical Sciences	64%
Life Sciences	14%

Selected Abstracts

Coexistence of Unverricht-Lundborg disease and congenital deafness: Molecular resolution of a complex comorbidity

EPILEPSIA, Issue 6 2009
Miljana Kecmanovi
Summary Purpose:, We report on genetic analysis of a complex condition in a Serbian family of four siblings, wherein two had progressive myoclonic epilepsy (PME) and congenital deafness (CD), one had isolated congenital deafness (ICD), and one was healthy. Methods and Results:, Molecular diagnosis performed by Southern blotting confirmed Unverricht-Lundborg disease in the available sibling with PME/CD. In the sibling with ICD (heterozygote for expansion mutation in CSTB) we demonstrated recombination event between the D21S2040 marker and the CSTB gene and identified c.207delC (p.T70Xfs) mutation in the fourth exon of the transmembrane protease, serine-3 (TMPRSS3) gene (maps in close proximity to CSTB), responsible for nonsyndromic deafness in the sibling with PME/CD as well. Discussion:, To the best of our knowledge this is the first genetic confirmation of the coexistence of these two mutations. [source]

Concepts in Social and Spatial Marginality

GEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 2 2000
Assefa Mehretu
The purpose of this paper is to present a conceptual taxonomy of marginality resulting from two counterposed structural conditions within laissez-faire on the one hand and controlled markets on the other. Marginality is a complex condition of disadvantage that individuals and communities may experience because of vulnerabilities which may arise from unequal or inequitable environmental, ethnic, cultural, social, political and economic factors. A typology of marginality is based on two primary and two derivative forms. The primary forms are contingent and systemic. The derivative forms are collateral and lever-aged. Contingent marginality is a condition that results from competitive inequality in which individuals and communities are put at a disadvantage because of the dynamics of the free market whose uncertain and stochastic outcomes affect them adversely. Systemic marginality is a socioeconomic condition of disadvantage created by socially constructed inequitable non-market forces of bias. Collateral marginality is a condition experienced by individuals or communities who are marginalized solely on the basis of their social and/or geographic proximity to individuals or communities that experience either contingent or systemic marginality. Lever-aged marginality is a contingent or systemic disadvantage that people/communities are made to experience when their bargaining position in free markets is weakened by dominant stakeholders like transnational corporations which are able to leverage lucrative concessions by using the threat of alternative, often cheaper and marginalized (contingent or systemic) labour pools to which they can potentially take their business. [source]

Obesity: the science behind the management

INTERNAL MEDICINE JOURNAL, Issue 5-6 2002
K. Steinbeck
Abstract The prevalence of obesity is increasing in Western and Westernizing countries. The changing environment plays a major role in this increase, particularly the reduction in physical activity. There is also a strong genetic contribution to the development of obesity, although single-gene defect obesity is rare. Neither the environment nor genes is simple to modify. Obesity is an energy-balance disorder, and the human body has evolved to resist any loss of body fat. This biological drive to maintain weight is coordinated through central pathways, with the involvement of many neuropeptides. Thus, dietary restriction will induce changes designed to counter weight loss, including a fall in resting metabolic rate. The management of obesity demands reasonable goals, which focus on metabolic, rather than cosmetic, improvement. As obesity is a complex condition, multiple therapeutic strategies are required. Dietary modification, an increase in physical activity, a reduction in sedentary activity and behaviour modification all form the basis of obesity therapy. Drug therapy options at present are limited and may have a stronger role in weight maintenance. Currently, surgical management of obesity has the best long-term outcomes. Long-term maintenance of weight loss is achieved by few individuals. Those individuals who are successful are able to maintain long-term restrictive eating habits and high levels of physical activity. (Intern Med J 2002; 32: 237,241) [source]

Clinical assessment and treatment of ADHD in children

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2007
L. C. Smoot
Summary Attention-deficit/hyperactivity disorder is a highly diagnosed psychiatric disorder in children. This widespread and complex condition requires extensive evaluation involving clinicians, parents and teachers. Proper management involves individual assessment and treatment. Psychostimulants remain the primary medication of choice as they have been shown to be efficacious for this condition. Newer, long-acting medications are providing expanded options for children and their caregivers. Failure to assess and treat can lead to serious long-term effects later in life. [source]

,-tocopherol, an exogenous factor of adult hippocampal neurogenesis regulation

JOURNAL OF NEUROSCIENCE RESEARCH, Issue 4 2003
Tiziana Cecchini
Abstract In previous work, we found that adult hippocampal neurogenesis in rat is affected by vitamin E deficiency. Because vitamin E deficiency is a complex condition involving numerous biological systems, it is possible that its effect on postnatal new neuron production could be mediated by unknown changes in different factors that in turn play a role in this process. To clarify if vitamin E plays a direct role in regulating hippocampal neurogenesis, we studied the neurogenesis in adult control rats and in adult rats under supplementation with ,-tocopherol, the most important compound of vitamin E. The ,-tocopherol level in control and supplemented rats was monitored. Qualitative and quantitative analysis of cell proliferation and death was carried out and expression of immature neuron markers PSA-NCAM, TUC 4, and DCX was investigated in hippocampus dentate gyrus. ,-Tocopherol levels increased significantly in both plasma and brain after supplementation. Cell proliferation was inhibited in ,-tocopherol-supplemented rats, the number of dying cells was reduced, and the number of cells expressing the immature neuron markers was increased. The results obtained confirm and extend the idea that vitamin E is an exogenous factor playing a direct role in regulation of different steps of adult hippocampal neurogenesis. Some hypotheses about the possible mechanisms underlying the complex action of ,-tocopherol, related to its antioxidant and molecule-specific non-antioxidant properties, are proposed and discussed. © 2003 Wiley-Liss, Inc. [source]

Tertiary paediatric obesity services in Australia

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2008
Pamela J Spilchak
Aim: To examine the nature and availability of paediatric obesity services in tertiary care settings across the states/territories of Australia. Methods: Surveys were sent to all clinicians identified as offering obesity services to children and adolescents. Respondents were asked to identify other service providers in their area, who were also asked to complete the survey. Results: Sixteen clinicians responded to the survey, from 20 requests. The clinicians who responded identified nine services in three of the eight states/territories of Australia. Existing services are limited to children and adolescents with severe obesity, with an average of 12 new referrals per service each month and an average waiting time of 5 months for an appointment. Most services involve a multidisciplinary approach, although the mix of staff varies considerably and emphasises nutrition rather than physical activity approaches. Conclusions: Despite the public attention devoted to paediatric obesity, tertiary services in Australia are inadequate to meet the increasing incidence and prevalence of this complex condition. The development of tertiary services as part of service delivery arrangements for paediatric obesity and its associated morbidities must become a priority within the health system. [source]

(0,2) Gauged linear sigma model on supermanifold

ANNALEN DER PHYSIK, Issue 7-8 2009
Y. Okame
Abstract We construct (0,2), D = 2 gauged linear sigma model on supermanifold with both an Abelian and non-Abelian gauge symmetry. For the purpose of checking the exact supersymmetric (SUSY) invariance of the Lagrangian density, it is convenient to introduce a new operator for the Abelian gauge group. The operator provides consistency conditions for satisfying the SUSY invariance. On the other hand, it is not essential to introduce a similar operator in order to check the exact SUSY invariance of the Lagrangian density of non-Abelian model, contrary to the Abelian one. However, we still need a new operator in order to define the (0,2) chirality conditions for the (0,2) chiral superfields. The operator can be defined from the conditions assuring the (0,2) supersymmetric invariance of the Lagrangian density in superfield formalism for the (0,2) U(N) gauged linear sigma model. We found consistency conditions for the Abelian gauge group which assure (0,2) supersymmetric invariance of Lagrangian density and agree with (0,2) chirality conditions for the superpotential. The supermanifold ,m|n becomes the super weighted complex projective space WCPm-1|n in the U(1) case, which is considered as an example of a Calabi-Yau supermanifold. The superpotential W(,,,) for the non-Abelian gauge group satisfies more complex condition for the SU(N) part, except the U(1) part of U(N), but does not satisfy a quasi-homogeneous condition. This fact implies the need for taking care of constructing the Calabi-Yau supermanifold in the SU(N) part. Because more stringent restrictions are imposed on the form of the superpotential than in the U(1) case, the superpotential seems to define a certain kind of new supermanifolds which we cannot identify exactly with one of the mathematically well defined objects. [source]

(0,2) Gauged linear sigma model on supermanifold

Chronic Hydrocephalus in Adults

BRAIN PATHOLOGY, Issue 3 2004
Richard J Edwards
Chronic hydrocephalus is a complex condition, the incidence of which increases with increasing age. It is characterised by the presence of ventricular enlargement in the absence of significant elevations of intracranial pressure. The clinical syndrome may develop either as a result of decompensation of a "compensated" congenital hydrocephalus, or it may arise de novo in adult life secondary to a known acquired disturbance of normal CSF dynamics. The latter may be due to late onset acqueductal stenosis or disruption of normal CSF absorptive pathways following subarachnoid hemorrhage or meningitis ("secondary" normal pressure hydrocephalus (NPH)). In some cases the cause of the hydrocephalus remains obscure ("idiopathic" NPH). In all forms of chronic hydrocephalus the clinical course of the disease is heavily influenced by changes in the brain associated with aging, in particular cerebrovascular disease. Recent research has challenged previously held tenets regarding the CSF circulatory system and this in turn has led to a radical rethinking of the pathophysiological basis of chronic hydrocephalus. [source]

Natural history of asthma from childhood to adulthood

CLINICAL & EXPERIMENTAL ALLERGY REVIEWS, Issue 4 2002
A. B. Kay
Summary Asthma is a common and complex condition, with considerable heterogeneity both in phenotype and in the underlying pathophysiology. This paper aims to address some of the recent advances in the understanding of asthma, as well as indicating how these advances reveal potential new avenues for therapeutic intervention. Current drug treatments, although effective at alleviating inflammatory symptoms, do little to target the underlying causative factors. The onset of asthma is controlled by a combination of genetic and environmental factors, and a greater understanding of these has highlighted the importance of early-life infections, allergen avoidance and fetal and postnatal nutrition. An imbalance in the expression of T-cell phenotypes is thought to play an important role in the pathophysiology of asthma, and further elucidation of the underlying immune mechanisms has identified new ways of modulating the course of the disease. It is clear that there is also a need for new drug strategies that are aimed at the diverse factors that both trigger the disease and determine its course and severity, as well as the immune mechanisms contributing to its pathophysiology. Treatment plans that address this diversity are likely to provide a more effective means of asthma management and, combined with current knowledge of causative factors, might even act to modulate the course and severity of the disease. [source]

Burns to persons suffering from diabetes: a systemic preventive approach

JOURNAL OF NURSING AND HEALTHCARE OF CHRONIC ILLNE SS: AN INTERNATIONAL INTERDISCIPLINARY JOURNAL, Issue 2 2009
MScN (edu), Ma'en Zaid Abu-Qamar Dnurs
Aims. To report the findings of an investigation of patients with diabetes and burns, with emphasis on implications for practice: primary and secondary preventions. Background. Diabetes and burns are complex conditions with multi-system involvements, which worsen outcomes for patients, and their management. This research investigated outcomes for patients and diabetes management. Methods. Data on outcomes were obtained from records of patients hospitalised for foot burns in an Australian hospital from 1999,2004. A questionnaire survey design was employed to obtain information on how clinicians in burns units manage diabetes. SPSS was used to analyse data obtained from both resources. Comments written in the questionnaire were analysed using relational analysis. Results. Of the 64 patients, 12 were with diabetes and 52 were without diabetes. Those with diabetes were more likely to sustain contact foot burns (58·3% Diabetes Mellitus vs. 13·5% non Diabetes Mellitus ,2 = 11·487, p = 0·002). The duration of hospitalisation was statistically significantly longer among patients with diabetes compared with those without diabetes (U = 169, p = 0·014); although the two groups were not statistically significant different in terms of severity of burns and received treatment. Of the 29 clinical leaders, 21 (72%) indicated that they regularly provided care to patients with diabetes. Most respondents (n = 15; 58%) reported that new plans need to be initiated to accommodate the combined insult of diabetes and burns. Diabetes centres were located in all participating sites; but not always involved in the process of care. Conclusion. The co-existence of diabetes and burns worsens outcomes for patients, and complicates management plans. Optimal management can be achieved via a multidisciplinary approach starting with glycaemic control, and continued to aggressive management of diabetes and burns. Relevance to clinical practice. Preventive measures should start with tight glycaemic control, identification and avoidance of sources of trauma, early detection and treatment, and continue to aggressive inpatient management of patients with both diabetes and a burn injury. [source]

Femur window,a new approach to microcirculation of living bone in situ

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2005
N. Hansen-Algenstaedt
Abstract Background: The processes of osteogenesis, bone remodelling, fracture repair and metastasis to bone are determined by complex sequential interactions involving cellular and microcirculatory parameters. Consequently studies targeting the analysis of microcirculatory parameters on such processes should mostly respect these complex conditions. However these conditions could not yet be achieved in vitro and therefore techniques that allow a long-term observation of functional and structural parameters of microcirculation in bone in vivo at a high spatial resolution are needed to monitor dynamic events, such as fracture healing, bone remodelling and tumor metastasis. Methods: We developed a bone chamber implant (femur window) for long-term intravital microscopy of pre-existing bone and its microcirculation at an orthotopic site in mice preserving the mechanical properties of bone. After bone chamber implantation vascular density, vessel diameter, vessel perfusion, vascular permeability and leukocyte-endothelial interactions (LEIs) in femoral bone tissue of c57-black mice (n = 11) were measured quantitatively over 12 days using intravital fluorescence microscopy. Furthermore a model for bone defect healing and bone metastasis in the femur window was tested. Results: Microvascular permeability and LEIs showed initially high values after chamber implantation followed by a significant decrease to a steady state at day 6 and 12, whereas structural parameters remained unaltered. Bone defect healing and tumor growth was observed over 12 and 90 days respectively. Conclusion: The new femur window design allows a long-term analysis of structural and functional properties of bone and its microcirculation quantitatively at a high spatial resolution. Altered functional parameters of microcirculation after surgical procedures and their time dependent return to a steady state underline the necessity of long-term observations to achieve unaltered microcirculatory parameters. Dissection of the complex interactions between bone and microcirculation enables us to evaluate physiological and pathological processes of bone and may give new insights especially in dynamic events e.g. fracture healing, bone remodeling and tumor metastasis. © 2005 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source]

Co-existent primary cutaneous anaplastic large cell lymphoma and lymphomatoid papulosis

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2003
G. Dawn
Summary We describe the case of a 37-year-old female with a history of psoriasiform dermatitis who presented with multicentric primary cutaneous CD30-positive anaplastic large T cell lymphoma (ALCL). Despite aggressive systemic therapy, the patient suffered multiple relapses and the lymphoma spread to cervical and inguinal lymph nodes. Later in her clinical course it was appreciated that she was also suffering from lymphomatoid papulosis (LyP). The case illustrates the overlapping clinical, histological and immunophenotypic features of ALCL and LyP, conditions which represent a spectrum of CD30-positive lymphoproliferative disease. A multidisciplinary approach between dermatologist, oncologist and pathologist is essential for the optimal management of these complex conditions. [source]

Growth hormone deficiency and combined pituitary hormone deficiency: does the genotype matter?

CLINICAL ENDOCRINOLOGY, Issue 2 2005
Mehul T. Dattani
Summary The past 12 years have witnessed an explosion in our understanding of the development of the anterior pituitary gland, and of mechanisms that underlie the diagnosis of growth hormone deficiency (GHD) and combined pituitary hormone deficiency (CPHD). The anterior pituitary is the end-product of a carefully orchestrated pattern of expression of signalling molecules and transcription factors that leads to the development of this complex organ secreting six hormones from five different cell types. Naturally occurring and transgenic murine models have demonstrated a role for many of these molecules in the aetiology of GHD/CPHD. These include the transcription factors HESX1, PROP1, POU1F1, LHX3, LHX4, GLI2 and SOX3. Depending upon the expression patterns of these molecules, the phenotype may consist of isolated hypopituitarism, or more complex disorders such as septo-optic dysplasia (SOD) and holoprosencephaly. The phenotype and the mode of inheritance can be highly variable. Novel mutations within the GH-1 and GHRHR genes have also shed light on the phenotype and pathogenesis of isolated GHD (IGHD). To date, genetic mutations have been identified in a modest proportion of patients with IGHD/CPHD and associated syndromes such as SOD. It is, however, clear that many genes remain to be identified, and characterization of these will further elucidate the pathogenesis of these complex conditions. [source]