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Consecutive Months (consecutive + month)
Selected AbstractsSurvival and vitality of Gremmeniella abietina on Pinus sylvestris slash in northern SwedenFOREST PATHOLOGY, Issue 6 2006J. Witzell Summary Survival and vitality of Gremmeniella abietina on Pinus sylvestris slash was studied in northern Sweden during 2003 and 2004. Once a month between September 2003 and April 2004, two to three trees were cut down and debranched. Shoots with pycnidia were sampled at the felling date and then at every consecutive month. The percentage of germinated conidia from each shoot was calculated after 24, 48 and 72 h incubation. The vitality of G. abietina pycnidia in the slash remained high the whole period. Intact pycnidia were found on slash several months after the time of conidial sporulation, which indicates that new pycnidia may be produced on dead pine branches. Sampling of shoots from slash on 13- to 18-month-old clear-cuts showed conidial germination capacity as high as in pycnidia collected in fresh slash. Due to survival of G. abietina in slash it is recommended to postpone planting of P. sylvestris seedlings in northern boreal areas to the third vegetation period after sanitary clear-cuts. Résumé La survie et la vitalité de Gremmeniella abietina dans des rémanents de Pinus sylvestris ont étéétudiées dans le nord de la Suède pendant les années 2003 et 2004. Une fois par mois entre septembre 2003 et avril 2004, 2 ou 3 arbres ont été abattus et ébranchés. Des pousses avec pycnides ont étééchantillonnées à la date d'abattage et les mois suivants. Le pourcentage de conidies germées a été calculé pour chaque pousse après 24, 48 et 72 heures d'incubation. La vitalité des pycnides de G. abietina dans les rémanents est restée élevée tout au long de la période. Des pycnides intactes ont été trouvées dans les rémanents plusieurs mois après la période de sporulation conidienne, ce qui suggère que de nouvelles pycnides peuvent être produites sur des branches mortes de pin. Des échantillonnages de pousses dans des rémanents de coupes rases réalisées 13,18 mois plus tôt ont montré une capacité de germination des conidies aussi élevée que dans les pycnides collectées dans des rémanents fraîchement coupés. Du fait de la survie de G. abietina dans les rémanents, il est conseillé de reporter la plantation des semis de P. sylvestris dans les zones septentrionales boréales à la troisième saison de végétation après les coupes sanitaires. Zusammenfassung Das Überleben und die Vitalität von Gremmeniella abietina auf Schlagabraum von Pinus sylvestris wurde in den Jahren 2003 und 2004 untersucht. Zwischen September 2003 und April 2004 wurden in jedem Monat einmal 2,3 Bäume gefällt und entastet. Zum Zeitpunkt des Fällens und in jedem folgenden Monat wurden Triebe mit Pyknidien gesammelt. Von jedem Trieb wurde die Keimrate der Konidien nach 24, 48 und 72 Stunden Inkubation bestimmt. Während der gesamten Beobachtungsdauer blieb die Vitalität der Pyknidien im Schlagabraum hoch. Mehrere Monate nach der Sporulation wurden intakte Pyknidien gefunden, ein Hinweis darauf, dass möglicherweise neue Pyknidien auf den toten Kiefernzweigen gebildet wurden. Auf dem Schlagabraum von 13,18 Monate alten Kahlschlägen war die Keimfähigkeit der Konidien ähnlich hoch wie bei Pyknidien von frischem Schlagabraum. Aufgrund des langen Überlebens von G. abietina in Schlagabraum wird für die nördlichen borealen Gebiete empfohlen, nach phytosanitären Kahlschlägen P. sylvestris -Sämlinge erst in der dritten Vegetationsperiode zu pflanzen. [source] The significance of a facultative bacterium to natural populations of the pea aphid Acyrthosiphon pisumECOLOGICAL ENTOMOLOGY, Issue 2 2003A. C. Darby Abstract. 1., Laboratory studies have implicated various accessory bacteria of aphids as important determinants of aphid performance, especially on certain plant species and under certain thermal regimes. One of these accessory bacteria is PABS (also known as T-type), which is distributed widely but is not universal in natural populations of the pea aphid Acyrthosiphon pisum in the U.K. 2., To explore the impact of PABS on the performance of A. pisum , the nymphal development time and fecundity of aphids collected directly from natural populations and caged on the host plant Vicia faba in the field were quantified. Over 4 consecutive months June,September 1999, the performance of PABS-positive and PABS-negative aphids did not differ significantly. 3., Deterministic modelling of the performance data showed that the variation in simulated population increase of PABS-positive and PABS-negative aphids would overlap substantially. 4., Analysis of aphids colonising five host plants ( Lathyrus odoratus , Medicago sativa , Pisum sativum , Trifolium pratense , Vicia faba ) between April and September 2000 and 2001, identified no robust differences between the distribution of PABS-positive and PABS-negative aphids on different plants and with season or temperature. 5., It is concluded that PABS is not an important factor shaping the performance or plant range of A. pisum under the field conditions tested. Reasons for the discrepancies between this study and laboratory-based studies are considered. [source] Intensity of drug injection as a determinant of sustained injection cessation among chronic drug users: the interface with social factors and service utilizationADDICTION, Issue 6 2004Julie Bruneau ABSTRACT Aims The objective of this study was to identify factors associated with sustained injection cessation and to examine further the relationship between the occurrence of sustained injection cessation of injection drug users (IDUs) and prior injection frequency. Design and setting IDUs in the Montreal St Luc Cohort who had at least three consecutive interviews between 1995 and 1999 were included. Sustained injection cessation was defined as a period of at least 7 consecutive months without injection. All IDUs completed interview-administered questionnaires on socio-demographic characteristics, drug and sexual behaviours and health-related issues. Logistic regression was used for analyses. Findings A total of 186/1004 (18.5%) IDUs reported a period of sustained injection cessation during the study period. In multivariate analysis, HIV-positive status, ,booting' and cumulative time spent in prison were negatively associated with injection cessation, while injection initiation after 35 years of age and frequent crack use were positively associated with injection cessation. We found a negative association between the occurrence of injection cessation and the frequency of injection; the odds ratios (OR) for cessation were 0.49 [95% confidence interval (CI): 0.03, 0.78] for IDUs who injected 30,100 times and 0.21 (95% CI: 0.10, 0.46) for IDUs who injected more than 100 times in the previous month. Attending needle exchange programmes (NEPs) or pharmacies appeared to be a modifier of the relation between cessation and prior injection frequency. The OR was 0.68 (95% CI: 0.42, 1.12) for IDUs who injected 30,100 times prior to injection and attended NEPs or pharmacies and was 0.07 (0.01, 0.30) for IDUs who did not use these services. Conclusions Overall, a fifth of IDUs experienced at least one episode of injection cessation of 7 months or more during a period of 4.5 years. Our data suggest that NEPs and pharmacies may have played a role in inducing injection cessation episodes in a subgroup of IDUs. Research is needed to better identify the characteristics of IDUs who could benefit from an injection cessation intervention strategy. This information is important for social and health policy planning. [source] Diel interactions between prey behaviour and feeding in an invasive fish, the round goby, in a North American riverFRESHWATER BIOLOGY, Issue 4 2006STEPHANIE M. CARMAN Summary 1. We studied the diet of the invasive round goby (Neogobius melanostomus) on a diel basis in the Flint River, a warmwater stream in Michigan, U.S.A. Diet and available prey samples were collected seven times over a 24 h period in four consecutive months. The section of river studied lacked zebra mussels (Dreissena polymorpha), the primary prey of adult round gobies elsewhere in the Great Lakes region. 2. Diet changed on a diel basis with hydropsychid caddisfly and chironomid larvae predominating during the day, chironomid pupae dominating in the evening and heptageniid mayflies dominating at night. Simultaneous study of macroinvertebrate drift suggested that caddisfly and chironomid larvae were most likely picked from submerged rocks, chironomid pupae were most likely taken during their emergent ascent and mayflies were either captured from the drift or picked from rocks. 3. The Flint River lacks a diverse darter (Family: Percidae) and sculpin (Family: Cottidae) fauna and it appears that the round goby has occupied a generalised darter/sculpin niche. Our results indicate that round gobies have the potential to invade successfully riverine systems, particularly those lacking a diverse benthic fish assemblage. [source] Mycobacterium fortuitum,induced persistent parotitis: Successful therapy with clarithromycin and ciprofloxacinHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 11 2007Chien-Cheng Chen MD Abstract Background. Parotitis caused by nontuberculous mycobacteria, a very rare disease entity, has never been reported to be caused by Mycobacterium fortuitum (M. fortuitum) in the literature. Methods and Results. An 8-year-old girl was seen with painful swelling of the right parotid gland despite antibiotic treatment of more than 1 month. Elevated serum amylase activity and diffuse contrast-enhanced CT of the parotid gland confirmed the diagnosis of parotitis. Histopathological study of specimens taken from the right parotid tail mass showed granulomatous inflammation with acid-fast positive bacilli; culture later confirmed M. fortuitum. After administration of clarithromycin and ciprofloxacin for 9 consecutive months, the parotitis and parotid tail mass were completely resolved at follow-up examination. Conclusion. To our knowledge, this is the first case report of parotitis caused by M. fortuitum and its successful medical treatment. © 2007 Wiley Periodicals, Inc. Head Neck, 2007 [source] 24-Hour Distribution of Migraine AttacksHEADACHE, Issue 1 2008Karl Alstadhaug MD Background., It is a widespread opinion that migraine attacks arise more frequently in the morning and that circadian rhythms may be responsible for the temporal pattern in migraine. However, only one small prospective study has previously been published on this topic. Objective., To investigate circadian variation in migraine. Method., Eighty-nine females in fertile age who had participated in a previous questionnaire-based study volunteered to prospectively record in detail every migraine attack for 12 consecutive months. We reviewed all diary entries covering the period from March 2004 through April 2005, and did time-series analysis. Results., Fifty-eight patients had complete recordings over the 12 months and 26 completed the diaries for 1,11 months. Three patients were excluded due to missing data and 2 patients were excluded due to chronic migraine or medication-overuse headache. A total of 2314 attacks were experienced, in average 27.5 per patient (range 1,75). By fitting a sine curve to the data there was a harmonic trend with a peak around 13.40 and the peak/low ratio was 25.6 (95% CI: 8.3,78.6). Conclusion., The main finding in our study is that migraine attacks tend to recur in a harmonic 24-hour cyclic manner with a peak around the middle of the day and that there is no difference between migraine with aura and migraine without aura regarding this. [source] Triage and mortality in 2875 consecutive trauma patientsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2010R. MEISLER Background: Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage. Methods: We prospectively registered all trauma patients in Eastern Denmark over 12 consecutive months. We analysed the flow of trauma patients through the system, the time spent at different locations, and we assessed the risk factors of mortality. Results: We included 2875 trauma patients, of whom 158 (5.5%) died before arrival at the hospital. Most patients (75.3%) were brought to local hospitals and patients primarily (n=82) or secondarily triaged (n=203) to the level I trauma centre were the most severely injured. Secondarily transferred patients spent a median of 150 min in the local hospital before transfer to the level I trauma centre and 48 min on transportation. Severe injury with an injury severity score >15 was seen in 345 patients, of whom 118 stayed at the local hospital. They had a significantly higher mortality than 116 of those secondarily transferred [45/118, 38.1% vs. 11/116, 9.7% (P<0.0001)]. Mortality within 30 days was 4.3% in admitted patients, and significant risk factors of death were violence [odds ratio (OR)=5.72], unconsciousness (OR=4.87), hypotension (OR=4.96), injury severity score >15 (OR=27.42), and age. Conclusions: Around 50% of all trauma deaths occurred at the scene. Increased survival of severely injured patients may be achieved by early transfer to highly specialised care. [source] Quantitative evaluation of Enterocytozoon bieneusi infection in simian immunodeficiency virus-infected rhesus monkeysJOURNAL OF MEDICAL PRIMATOLOGY, Issue 2 2003K. Sestak Abstract: The association of the microsporidia Enterocytozoon bieneusi with chronic diarrhea and wasting in individuals with acquired immunodeficiency syndrome (AIDS) has been demonstrated. The disease caused by E. bieneusi has been linked to decreased levels of circulating CD4+ T lymphocytes. In this study, we investigated the relationship between the extent of excretion of E. bieneusi in feces of simian immunodeficiency virus (SIV)-infected juvenile macaques and the CD4+ T lymphocyte counts in the peripheral blood. Twelve juvenile rhesus monkeys (Macaca mulatta) were intravenously inoculated with the pathogenic molecular clone SIVmac239. Numbers of CD4+ T lymphocytes were assessed by three-color flow cytometry. The presence of E. bieneusi DNA in feces was assessed by nested PCR. In addition, selected samples of feces were examined by competitive quantitative PCR to assess the level of E. bieneusi infection. Low (n = 5) to undetectable (n = 7) quantities of E. bieneusi were present in feces of the twelve animals in prior to inoculation with SIV. After SIV inoculation the number of animals shedding E. bieneusi increased (n = 10) as did the quantity of E. bieneusi shedding in the feces. Of the twelve juvenile animals, five animals died within 8 months post-SIV inoculation with symptoms of AIDS. Four of the five deceased animals showed shedding of E. bieneusi DNA in feces (,100 spores/g) for at least three consecutive months. Increased number of E. bieneusi in feces was accompanied by decreased counts of circulating CD4+ T lymphocytes and increased SIV plasma viral load. [source] Expatriates in High,UV Index and Tropical Countries: Sun Exposure and Protection Behavior in 9,416 French AdultsJOURNAL OF TRAVEL MEDICINE, Issue 2 2007Khaled Ezzedine MD Background Overexposure to sunlight during long stays in tropical countries can reveal short- and long-term harmful effects on the skin of Caucasian residents, especially for fair-skinned subjects. The aim of this study was to describe sun exposure and sun protection behaviors during lifetime among French adults who declared having experienced at least one expatriation period in tropical or high,sun index areas for a duration of more than three consecutive months. Methods A self-reported questionnaire on sun exposure behavior was addressed two times, in 1997 and 2001, to the 12,741 French adult volunteers enrolled in the SU.VI.MAX cohort. A total of 8,084 subjects answered to the first survey and 1,332 additional responders answered to the second. Among the 9,416 individuals, 1,594 (652 women and 942 men) corresponded to expatriates and the remaining 7,822 to nonexpatriates (4,972 women and 2,850 men). A descriptive analysis of sun exposure and sun protection behaviors during lifetime of expatriates and nonexpatriates was performed by gender. Results Among women, 39% of expatriates belonged to the 50 to 60 class of age at inclusion, versus 33% in nonexpatriates (72 and 55% in men, respectively). In women, expatriates declared more frequently having during lifetime exposed voluntarily their skin to the sun, practiced tanning between 11 a.m. and 4 p.m., less gradually exposed their skin, experienced intensive sun exposure, and exposed their skin during nautical sports and practiced naturism. In men, expatriates declared more frequently having experienced intensive sun exposure and exposed their skin during outdoor occupations and during nautical and mountain sports. Conclusions Although expatriates are aware of travel health advices concerning the countries where they planned to stay, they are usually poorly informed about sun exposure risk factors. Such individuals who planned to expatriate in countries with a high ultraviolet index should benefit from a visit to a travel clinic including specific health care information for risk related to sun exposure, ie, skin cancers and photoaging. [source] Results from the Wide Angle Search for Planets Prototype (WASP0) , III.MONTHLY NOTICES OF THE ROYAL ASTRONOMICAL SOCIETY, Issue 3 2005Planet hunting in the Draco field ABSTRACT The Wide Angle Search for Planets Prototype (WASP0) is a wide-field instrument used to search for extra-solar planets via the transit method. Here we present the results of a monitoring program which targeted a 9-degree field in Draco. WASP0 monitored 35 000 field stars for two consecutive months. Analysis of the light curves resulted in the detection of 11 multi-transit candidates and three single-transit candidates, two of which we recommend for further follow-up. Monte Carlo simulations matching the observing parameters estimate the expected number of transit candidates from this survey. A comparison of the expected number with the number of candidates detected is used to discuss limits on planetary companions to field stars. [source] Randomized controlled trial of short-term withdrawal of i.v. immunoglobulin therapy for selected children with human immunodeficiency virus infectionPEDIATRICS INTERNATIONAL, Issue 6 2007GALIA GRISARU-SOEN Abstract Background: The aim of the present paper was to determine whether monthly i.v. immunoglobulin (IVIG) could be safely discontinued in antiretroviral-treated human immunodeficiency virus (HIV)-infected children. Methods: In a double-blind cross-over trial, children ,18 years with HIV infection, well controlled on antiretroviral therapy, were randomized to alternating courses of 3 consecutive months of IVIG (400 mg/kg once a month) and 3 consecutive months of placebo for 1 year. The primary outcome was days of fever per month. Secondary outcomes were frequency of serious infections, changes in HIV viral load (VL), CD4+ counts and IgG levels. Results: Fifteen children were enrolled. Using the revised pediatric HIV clinical classification system of the Centers for Disease Control and Prevention, eight were severely symptomatic (C), four were moderately symptomatic (B) and three were mildly symptomatic (A). There were no statistically significant outcome measures. The mean number of days of fever per month with IVIG versus placebo was 0.55 days versus 1.48 days (P = 0.11). The difference was 0.9 days (95% confidence interval: +2.05 to ,0.25). There were no serious infections in either period. For the IVIG versus placebo periods, mean CD4 counts were 970 cells/,L versus 906 cells/,L (P = 0.12), VL 2.90 log10 copies/mL versus 2.82 log10 copies/mL (P = 0.70) and IgG levels were 17.41 g/L versus 16.6 g/L (P = 0.13). Conclusion: In antiretroviral-treated HIV-infected children short-term withdrawal of monthly IVIG was not associated with a significant increase in incidence of infections or a decline in immunologic function (CD4 count, viral load and IgG levels). These results suggest that monthly IVIG can be safely discontinued in HIV-infected children who are clinically stable and receiving combination antiretroviral therapy. [source] Increasing herbal product consumption in Thailand,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 9 2006Arthorn Riewpaiboon PhD Abstract Purpose The aim of this study was to investigate expenditures and categories of herbal product consumption in drugstores in Thailand. Methods The study was designed as a cross-sectional descriptive research. Study population was drugs and foods produced from herbs sold in all registered drugstores in Thailand. Regarding sampling, one province was selected from each of 13 regions by convenience sampling. Drugstores in each province were included at a proportion of 1% of the population by a convenience sampling method. Purchasing documents of the drugstores were collected for two consecutive months in 2001 and 2003. The medians of prices were used to estimate value of the whole country. Results The sample included 129 and 121 drugstores in 2001 and 2003, respectively. Total consumption was 27 and 32 million US$ (1 US$,=,40 Thai baht) in the year 2001 and 2003, respectively. At constant prices, this represented an increase of 11%. The five top-ranked categories of products used in 2003 were haematonics, post-delivery drugs, anti-constipation, anti-cough, and cardiotonics. Conclusions Herbal product consumption increased by 11% from 2001 to 2003. To cover the full range of consumption of herbal products, further studies should include other outlets, for example hospital and direct sales. Copyright © 2005 John Wiley & Sons, Ltd. [source] The reproducibility of ethnic differences in the proportional awake,sleep blood pressure decline among womenAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2010Helene M. Van Berge-Landry A growing body of evidence indicates that African Americans (AA), on average, have a smaller proportional decline in blood pressure (BP) from waking to sleep than European Americans (EA), but this difference is largely based on correlational data from a single assessment day. The persistence of this difference over repeated sampling is not well established. The purpose of this study was to evaluate whether ethnic differences in the awake,sleep BP decline between AA and EA persisted over three monthly assessments. The subjects were 47 AA (age = 39.7 ± 8.7) and 92 EA (age = 37.4 ± 9.2) normotensive women. Subjects had 24-h ambulatory BP monitoring done on midweek workdays at 1-month intervals for three consecutive months. The proportional decline in BP was calculated as follows: (average awake , average sleep)/average sleep. The persistence of ethnic differences was evaluated using repeated-measures ANCOVA and by examining Bland,Altman plots. The ANCOVA results revealed that overall, the proportional decline of AA women was less than that of EA women for both SBP (P < 0.038) and DBP (P < 0.083), consistent with previous research, and that there were also no significant ethnic differences by monthly assessment. Bland,Altman plots revealed that overall and by ethnicity, the proportional decline in BP among individual subjects over the 3 months was also reproducible. These results suggest that the ethnic difference in awake,sleep BP between AA and EA women persists over time and that the awake,sleep decline in BP among individuals, whether AA or EA, is also reproducible. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] The relationship between chronic rhinosinusitis and occupation: The 1998, 2001, and 2005 Korea National health and nutrition examination survey (KNHANES),AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2009Dong-Hee Koh MD, DrPH Abstract Objectives We examined the relationship between chronic rhinosinusitis and occupation. Methods We analyzed data from the 1998, 2001, and 2005 Korea National Health and Nutrition Examination Survey (KNHANES). Men and women aged 20,59 who participated in the three KNHANES were included to analyze the relationship between chronic rhinosinusitis and occupation. Trained interviewers visited subjects' homes and administered a standardized questionnaire on diagnosed diseases. Subjects were asked if they had experienced chronic rhinosinusitis during the previous year or had had rhinosinusitis for three or more consecutive months. Occupational classification followed the major groups of the Korean Standard Classification of Occupations (KSCO). We calculated the prevalence ratios (PRs) of chronic rhinosinusitis by major groups compared with clerical workers in the three KNHANES. Poisson regression with robust standard error was conducted, adjusting for age in 10-year strata. Results There were significantly increased PRs of chronic rhinosinusitis in plant and machinery operators and assemblers, elementary occupations, crafts and related trade workers, and the unemployed. Conclusions These results support the relationship between chronic rhinosinusitis and occupational exposure at the macro level. Am. J. Ind. Med. 52:179,184, 2009. © 2008 Wiley-Liss, Inc. [source] Cancer incidence rates among Lawrence Livermore National Laboratory (LLNL) employees: 1974,1997,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2004M. Donald Whorton MD Abstract Background In the mid-1970's an excess of malignant melanoma of the skin was noted among employees at the Lawrence Livermore National Laboratory (LLNL). A 1984 cancer incidence study showed a non-significant excess of total cancers among female employees with significant excesses for melanoma, rectum and anus, and salivary gland cancers. For male employees, there was a non-significant deficit of total cancer with significant excesses in melanoma and non-brain nervous system cancers. This paper reports the results of a surveillance effort to update our understanding of the patterns of cancer incidence in this population. Methods We used California Cancer Registry (CCR) data to ascertain employees who had worked for six or more consecutive months at LLNL during the 24-year period of 1974 through 1997 who were diagnosed weith cancer during that time frame. We used the Standardized Incidence Ratio (SIR) in our analyses. Results There were 17,785 employees who provided 186,558 person-years of observation: 145,203 were from males and 41,355 were from females. The CCR, through its linkage techniques, identified 541 individuals with invasive cancer and 96 with in situ cancer. A total of 404 males had invasive cancer and 33 had in situ cancer whereas there were 137 females with invasive cancer and 63 with in situ cancer. The SIR for invasive cancer in males was 69 (95% CI 62,76). The overall cancer SIR for males was unaffected by calendar time. There were only two invasive cancer sites with significant excess: melanoma and cancer of the testes. For eight categories or cancer sites, we found a statistical deficit in cancer incidence. The most striking deficit occurred in cancer of the lungs and bronchus with a SIR of 36 (95% CI 26,50). The SIR for invasive cancer in females was 80 (95% CI 67,94). The overall cancer SIR for females decreased over calendar time. There was a statistically significant deficit for cancers of the female genital organs. There were 84 cases of invasive and in situ melanoma in both genders. Time-trend analyses for melanoma showed a significant excess during the years 1974,1985 but a reduction to community rates from 1986 through 1997. There were 21 individuals with testicular cancer with a SIR of 207 (95% CI 129,317). There were no differences in age at diagnosis or cell type with the comparison population. We analyzed the data using the same radiosensitive cancer categories used in the 1984 study. There were no increases in SIRs in any of these categories. Conclusions We found that the LLNL employees had less cancer than expected with males having relatively fewer cancers than females. The lung cancer rate for males was remarkably low. Since 1986 the melanoma rates resemble the community rates. Testicular cancer rates are modestly elevated and appear to have been so for the past 20 years. Lifestyle patterns, including smoking, and cancer screening activities are probably important contributors to the observed low cancer rates. Am. J. Ind. Med. 45:24,33, 2004. © 2003 Wiley-Liss, Inc. [source] Mating promiscuity and reproductive tactics in female black and gold howler monkeys (Alouatta caraya) inhabiting an island on the Parana river, ArgentinaAMERICAN JOURNAL OF PRIMATOLOGY, Issue 8 2010Martin M. Kowalewski Abstract In several primate species, females mate promiscuously and several adult males peacefully co-reside in the same social group. We investigated female mating behavior in two neighboring multimale,multifemale groups of Alouatta caraya in northern Argentina (27°20,S,58°40,W). All adult individuals in each group were marked with identification anklets and ear tags, and followed for five consecutive full days per month during 20 consecutive months. We recorded 219 copulations for eight resident females in these two groups. Thirty-two percent of matings involved extra-group copulations and 68% were with resident males. During periods when females were likely to conceive and during periods when females were nonfertile (pregnancy and lactation), there were no significant differences in the average number of resident and nonresident males with which they copulated (G -test: Gadj=0.1, df=3, P>0.05). In both of our study groups, adult males were tolerant of the mating activities between resident males and resident females, but acted aggressively and collectively (howling, border vigilance, and fighting) when extragroup males attempted to enter the group and mate with resident females. Given the frequency of extragroup matings, we examined the distance females traveled to engage in these copulations, time engaged in pre- and postcopulatory behavior, and the risk of injury during extragroup copulations. These costs were found to be relatively small. We suggest that female promiscuity is the prime driver or constraint on male reproductive opportunities in this species. Female promiscuity in A. caraya appears to represent a mixed mating strategy that may serve to increase opportunities for genetic diversity between a female's successive offspring as well as minimize the risk of infanticide by spreading paternity estimates across a larger number of adult males. Am. J. Primatol. 72:734,748, 2010. © 2010 Wiley-Liss, Inc. [source] Causes for cancellation of elective surgical procedures in a Spanish general hospitalANAESTHESIA, Issue 5 2009A. González-Arévalo Summary Cancellation of scheduled surgery is undesirable for patients and an inefficient use of resources. We prospectively collected data for 52 consecutive months in a public general hospital to estimate the prevalence and causes. The overall cancellation rate was 6.5% (2559 of 39 115 scheduled operations). Cancellation by broad category was for ,medical reasons' in 50%, ,patient-related factors' in 23%, and due to ,administrative/logistic problems' in 25%. The commonest specific causes within these categories were respectively: infections/fever (18%), patient did not attend (20%) and lack of theatre time (23%). This data will help direct resources to target prevention of cancellations as a result of these main problems. [source] Antimalarial treatment may have a time-dependent effect on lupus survival: Data from a multinational Latin American inception cohortARTHRITIS & RHEUMATISM, Issue 3 2010Samuel K. Shinjo Objective To evaluate the beneficial effect of antimalarial treatment on lupus survival in a large, multiethnic, international longitudinal inception cohort. Methods Socioeconomic and demographic characteristics, clinical manifestations, classification criteria, laboratory findings, and treatment variables were examined in patients with systemic lupus erythematosus (SLE) from the Grupo Latino Americano de Estudio del Lupus Eritematoso (GLADEL) cohort. The diagnosis of SLE, according to the American College of Rheumatology criteria, was assessed within 2 years of cohort entry. Cause of death was classified as active disease, infection, cardiovascular complications, thrombosis, malignancy, or other cause. Patients were subdivided by antimalarial use, grouped according to those who had received antimalarial drugs for at least 6 consecutive months (user) and those who had received antimalarial drugs for <6 consecutive months or who had never received antimalarial drugs (nonuser). Results Of the 1,480 patients included in the GLADEL cohort, 1,141 (77%) were considered antimalarial users, with a mean duration of drug exposure of 48.5 months (range 6,98 months). Death occurred in 89 patients (6.0%). A lower mortality rate was observed in antimalarial users compared with nonusers (4.4% versus 11.5%; P< 0.001). Seventy patients (6.1%) had received antimalarial drugs for 6,11 months, 146 (12.8%) for 1,2 years, and 925 (81.1%) for >2 years. Mortality rates among users by duration of antimalarial treatment (per 1,000 person-months of followup) were 3.85 (95% confidence interval [95% CI] 1.41,8.37), 2.7 (95% CI 1.41,4.76), and 0.54 (95% CI 0.37,0.77), respectively, while for nonusers, the mortality rate was 3.07 (95% CI 2.18,4.20) (P for trend < 0.001). After adjustment for potential confounders in a Cox regression model, antimalarial use was associated with a 38% reduction in the mortality rate (hazard ratio 0.62, 95% CI 0.39,0.99). Conclusion Antimalarial drugs were shown to have a protective effect, possibly in a time-dependent manner, on SLE survival. These results suggest that the use of antimalarial treatment should be recommended for patients with lupus. [source] Treatment of rheumatoid arthritis with anakinra, a recombinant human interleukin-1 receptor antagonist, in combination with methotrexate: Results of a twenty-four,week, multicenter, randomized, double-blind, placebo-controlled trialARTHRITIS & RHEUMATISM, Issue 3 2002Stanley Cohen Objective To evaluate the efficacy and safety of anakinra in combination with methotrexate (MTX) in patients with active rheumatoid arthritis (RA). Methods Patients with moderate-to-severe active RA who were receiving MTX for 6 consecutive months, with stable doses for ,3 months (those with disease duration of >6 months but <12 years) were randomized into 6 groups: placebo or 0.04, 0.1, 0.4, 1.0, or 2.0 mg/kg of anakinra administered in a single, daily, subcutaneous injection. The primary efficacy end point was the proportion of subjects who met the American College of Rheumatology 20% improvement criteria (attained an ACR20 response) at week 12. Results A total of 419 patients were randomized in the study. Patient demographics and disease status were similar in the 6 treatment groups. The ACR20 responses at week 12 in the 5 active treatment plus MTX groups demonstrated a statistically significant (P = 0.001) dose-response relationship compared with the ACR20 response in the placebo plus MTX group. The ACR20 response rate in the anakinra 1.0-mg/kg (46%; P = 0.001) and 2.0-mg/kg (38%; P = 0.007) dose groups was significantly greater than that in the placebo group (19%). The ACR20 responses at 24 weeks were consistent with those at 12 weeks. Similar improvements in anakinra-treated subjects were noted in individual ACR components, erythrocyte sedimentation rate, onset of ACR20 response, sustainability of ACR20 response, and magnitude of ACR response. Anakinra was safe and well tolerated. Injection site reaction was the most frequently noted adverse event, and this led to premature study withdrawal in 7% (1.0-mg/kg group) to 10% (2.0-mg/kg group) of patients receiving higher doses. Conclusion In patients with persistently active RA, the combination of anakinra and MTX was safe and well tolerated and provided significantly greater clinical benefit than MTX alone. [source] Electronic e-isotretinoin prescription chart: Improving physicians' adherence to isotretinoin prescription guidelinesAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2009Mark BY Tang ABSTRACT Oral isotretinoin is a highly effective treatment for refractory nodulocystic acne. However, it can be associated with serious adverse effects such as teratogenicity and hepatitis. Inadequate cumulative dosing may also result in reduced therapeutic efficacy and higher disease relapse. A preliminary audit had previously revealed a poor and inconsistent adherence to local isotretinoin prescribing guidelines by physicians. To achieve greater than 90% adherence to isotretinoin guidelines for all acne patients prescribed systemic isotretinoin at the National Skin Centre, Singapore, key areas and the reasons for non-adherence were identified. A specifically designed ,one-stop' electronic isotretinoin chart was launched within the electronic medical records (EMR) system to address important safety areas; namely, informed patient consent, pregnancy testing, baseline laboratory tests, and automatic calculation of cumulative and target doses of isotretinoin. Physician adherence to prescribing guidelines improved from a baseline of 50,60% to greater than 90% (range 95,100%) for 30 consecutive months post intervention. The e-isotretinoin chart has resulted in significant improvement in physicians' adherence to isotretinoin prescription guidelines and highlights the utility of EMR technology in influencing safe prescribing behaviour among doctors. [source] Prevalence of urinary incontinence in women with cystic fibrosisBJU INTERNATIONAL, Issue 1 2001M. Cornacchia Objective To determine the prevalence of urinary incontinence (UI) in female patients (aged 15 years) attending a cystic fibrosis (CF) centre, in whom stress UI could be common, as chronic coughing and sputum production are frequent symptoms associated with progressive lung disease in these patients. Patients and methods An anonymous questionnaire was completed by 176 women with CF (mean age 24.6 years, sd 5.8) during routine assessments as outpatients. Results In all, 72 patients (41%) were classified as never incontinent; occasional UI was reported in 61 women (35%). Regular UI, occurring twice or more a month for at least two consecutive months in the last year, was reported in 43 patients (24%). Regular UI was associated with increasing age and a lower mean (sd) forced expiratory volume/s (of that predicted) than in women with no urinary symptoms, at 26.9 (6.5) years and 53.5 (23.5)%, and 23.1 (5.4) years and 65.5 (23.2)%, respectively (P < 0.01 and P < 0.05, respectively). All incontinent women recorded stress UI; coughing, laughing and physical activity were associated with UI in 92%, 33% and 21% of the patients, respectively. Conclusion Stress UI is a common symptom in women with CF. As urine loss can be under-reported to the healthcare providers, women should be asked about incontinence as part of their routine follow-up. Pelvic floor muscle exercises are effective in treating stress UI and should be considered for those with CF and regular UI. [source] Comparison of Adverse Events during Procedural Sedation between Specially Trained Pediatric Residents and Pediatric Emergency Physicians in IsraelACADEMIC EMERGENCY MEDICINE, Issue 7 2008Itai Shavit MD Abstract Objectives:, The aim was to compare the rate of procedural sedation,related adverse events of pediatric residents with specific training in "patient safety during sedation" and pediatric emergency physicians (PEPs) who completed the same course or were teaching faculty for it. Methods:, This prospective single-blinded, nonrandomized study was conducted in two university-affiliated pediatric emergency departments (PEDs) in Israel. Pediatric residents who were authorized to perform unsupervised sedations had previously completed a course in patient safety during sedation. Unsupervised sedations by residents were defined as sedations where the entire procedure was performed independently. Study subjects had autonomy in choosing medications for sedation. Adverse events were defined as transient hypoxia (oxygen saturation , 90%) or apnea. Adverse outcomes were situations where intubation or hospitalization directly related to sedation complications would occur. Sedations over 12 consecutive months were recorded, and rates of adverse events in each group were compared. Results:, A total of 984 eligible sedations were recorded, 635 by unsupervised residents and 349 by PEPs. A total of 512 (80.6%) sedations were performed by residents when attending physicians were not in the ED. The total adverse event rate was 24/984 (2.44%). When the two groups used a similar type drugs, residents had 8/635 (1.26%) events, compared to 11/328 (3.35%) by PEPs. There was no statistically significant difference in the rates of hypoxia or apnea between the two groups (p = 0.29 and p = 0.18, respectively). Adverse outcomes did not occur. Conclusions:, Unsupervised pediatric residents with training in patient safety during sedation performed procedural sedations with a rate of adverse events similar to that of PEPs. [source] Atypical Clinical Features of Pediatric AppendicitisACADEMIC EMERGENCY MEDICINE, Issue 2 2007Theresa Becker DO Background The diagnosis of appendicitis remains challenging in children. Delays in diagnosis, or misdiagnosis, have important medical and legal implications. The typical, or classic, presentation of pediatric appendicitis has been modeled after adult disease; however, many children present atypically with subtle findings or unusual signs. Objectives To determine the frequency of atypical clinical features among pediatric patients with appendicitis and to investigate which atypical features are the strongest negative predictors for appendicitis among patients being evaluated for appendicitis. Methods Children and adolescents with suspected appendicitis were enrolled over 20 consecutive months. Pediatric emergency physicians completed standardized data collection forms on eligible patients. Final diagnosis was determined by pathology or follow-up telephone call. Typical and atypical findings were defined strictly a priori. Results Seven hundred fifty-five patients were enrolled. The median age was 11.9 years (interquartile range [IQR]: 8.5, 14.9 yr); 36% of patients were diagnosed with appendicitis. Among patients with appendicitis, the most common atypical features included absence of pyrexia (83%), absence of Rovsing's sign (68%), normal or increased bowel sounds (64%), absence of rebound pain (52%), lack of migration of pain (50%), lack of guarding (47%), abrupt onset of pain (45%), lack of anorexia (40%), absence of maximal pain in the right lower quadrant (32%), and absence of percussive tenderness (31%). Forty-four percent of patients with proven appendicitis had six or more atypical characteristics. The median number of atypical features for patients with proven appendicitis was five (IQR: 4.0, 7.0). The greatest negative predictors, on the basis of likelihood ratios, were as follows: white blood cell count (WBC) of <10,000 per cubic millimeter (likelihood ratios [LR], 0.18), absolute neutrophil count (ANC) of <7,500 per cubic millimeter (LR, 0.35), lack of percussive tenderness (LR, 0.50), lack of guarding (LR, 0.63), and no nausea or emesis (LR, 0.65). Conclusions Appendicitis in pediatric patients is difficult to diagnose because children present with a wide variety of atypical clinical features. Forty-four percent of patients with appendicitis presented with six or more atypical features. Two atypical features are the strongest negative predictors of appendicitis in children: WBC of <10,000 per cubic millimeter and an ANC of <7,500 per cubic millimeter. [source] | |||||||||||||