Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Deterioration

  • acute deterioration
  • acute respiratory deterioration
  • climatic deterioration
  • clinical deterioration
  • cognitive deterioration
  • environmental deterioration
  • function deterioration
  • functional deterioration
  • gradual deterioration
  • graft deterioration
  • joint deterioration
  • marked deterioration
  • mental deterioration
  • neurological deterioration
  • performance deterioration
  • progressive deterioration
  • quality deterioration
  • rapid deterioration
  • renal deterioration
  • respiratory deterioration
  • significant deterioration
  • structural deterioration
  • subsequent deterioration
  • visual deterioration
  • water quality deterioration

  • Terms modified by Deterioration

  • deterioration rate
  • deterioration scale

  • Selected Abstracts


    P Lewindon Assoc Professor
    No abstract is available for this article. [source]


    ARCHAEOMETRY, Issue 2 2009
    A. M. A. MOUSSA
    The wall paintings of Al Qurna in Egypt were studied by means of XRD and ICP,AES in order to determine their mineralogical and chemical composition, and to evaluate the impact of soluble salts on their deterioration, including the identification of the building materials and pigments used. Soluble salts analysis showed that NaCl is the most common soluble salt in the bedrock, ground water and surface water samples. The building materials are affected by the ground water, while the wall paintings in the area are affected by the Upper Egypt climatic conditions, which were studied in order to detect their role in the deterioration cycle in the area. [source]

    Continuing Progressive Deterioration of the Environment in the Aral Sea Region: Disastrous Effects on Mother and Child Health

    ACTA PAEDIATRICA, Issue 5 2001
    O Ataniyazova
    Scientists, non-governmental experts (NGOs) and governmental officials from the Central Asian Republics and an international group of invited scientists and NGO representatives participated in a workshop on the disastrous health problems in the Aral Sea Region. Various serious problems were reported in more than 20 presentations. Particular emphasis was put on the way in which adverse environmental factors such as contaminated water and food have contributed to the deterioration of human health, particularly that of mothers and children. Conclusion: There is an urgent request that the international community assists local scientists to develop programmes to improve the health of the population in the Aral Sea Region. [source]

    Reducing the duration of untreated first-episode psychosis , effects on baseline social functioning and quality of life

    I. Melle
    Objective:, Long duration of untreated psychosis (DUP) is associated with poorer outcome. The TIPS study demonstrated that DUP can be reduced through early detection (ED). As quality of life (QoL) is associated with DUP it is expected that reduction of DUP leads to better QoL. Method:, Consecutive first-episode patients with a DSM-IV diagnosis of non-organic, non-affective psychosis were included, 281 patients gave informed consent and 263 completed a full evaluation of QoL. Results:, There were no differences in subjective QoL between ED and No-ED groups attributable to reduction in DUP. There were significant bivariate differences in frequency of family and social contacts in favor of the ED group, but multivariate analyses indicated that these differences were based on differences in sample characteristics. Conclusion:, Deterioration in QoL may precede overt symptom formation. Focus on functional loss in ED educational campaigns may identify risk subjects earlier in the course of the disorder. [source]

    Salinization of a Fresh Palaeo-Ground Water Resource by Enhanced Recharge

    GROUND WATER, Issue 1 2003
    F.W. Leaney
    Deterioration of fresh ground water resources caused by salinization is a growing issue in many arid and semi-arid parts of the world. We discuss here the incipient salinization of a 104 km2 area of fresh ground water (<3000 mg/L) in the semiarid Murray Basin of Australia caused by widespread changes in land use. Ground water 14C concentrations and unsaturated zone Cl soil water inventories indicate that the low salinity ground water originated mainly from palaeo-recharge during wet climatic periods more than 20,000 years ago. However, much of the soil water in the 20 to 60 m thick unsaturated zone throughout the area is generally saline (> 15,000 mg/L) because of relatively high evapotranspiration during the predominantly semiarid climate of the last 20,000 years. Widespread clearing of native vegetation over the last 100 years and replacement with crops and pastures leads to enhancement of recharge rates that progressively displace the saline soil-water from the unsaturated zone into the ground water. To quantify the impact of this new hydrologic regime, a one-dimensional model that simulates projected ground water salinities as a function of depth to ground water, recharge rates, and soil water salt inventory was developed. Results from the model suggest that, in some areas, the ground water salinity within the top 10 m of the water table is likely to increase by a factor of 2 to 6 during the next 100 years. Ground water quality will therefore potentially degrade beyond the point of usefulness well before extraction of the ground water exhausts the resource. [source]

    Analytical study of mine closure behaviour in a poro-visco-elastic medium

    H. Wong
    Abstract This paper is interested in the hydro-mechanical behaviour of an underground cavity abandoned at the end of its service life. It is an extension of a previous study that accounted for a poro-elastic behaviour of the rock mass (Int. J. Comput. Geomech. 2007; DOI: 10.1016/j.compgeo.2007.11.003). Deterioration of the lining support with time leads to the transfer of the loading from the exterior massif to the interior backfill. The in situ material has a poro-visco-elastic constitutive behaviour while the backfill is poro-elastic, both saturated with water. This loading transfer is accompanied by an inward cavity convergence, thereby compressing the backfill, and induces an outward water flow. This leads to a complex space,time evolution of pore pressures, displacements and stresses, which is not always intuitive. In its general setting, a semi-explicit solution to this problem is developed, using Laplace transform, the inversion being performed numerically. Analytical inversion leading to a quasi-explicit solution in the time domain is possible by identifying the characteristic creep and relaxation times of volumetric strains with those of the deviatoric strains, on the basis of a parametric study. A few numerical examples are given to illustrate the hydro-mechanical behaviour of the cavity and highlight the influence of key parameters (e.g. stiffness of backfill, lining deterioration rate, etc.). Further studies accounting for more general material behaviours for the backfill and external ground are ongoing. Copyright © 2008 John Wiley & Sons, Ltd. [source]

    Fabrication and Application of an Oxide Thermoelectric System

    Ryoji Funahashi
    A plate-shaped thermoelectric module was prepared using 140 pairs of p -type Ca3Co4O9 (Co-349) and n -type LaNiO3 (Ni-113) bulks. The hot-pressed thermoelectric oxide bulks were connected with an Ag paste, incorporating oxide powder, and Ag sheets. The module's open-circuit voltage increases with increasing hot-side temperature (TH) and reaches 4.5 V at a TH of 1072 K in air. No deterioration in output power was seen when power generation was carried out 10 times at a TH of 723 K with intermediate cooling to room temperature. The module was successfully used to charge a lithium-ion battery in a mobile phone. Thermoelectric modules composed of p -type Co-349 and n -type CaMnO3 (Mn-113) bulks, which have a pipe shape, were constructed using Ag electrodes and stainless-steel tubes. The devices were connected with the stainless-steel tube coated with ZrO2 by thermal spray using a dielectric paste composed of silica glass and iron oxide. Power generation was carried out in flame by combustion of natural gas. Water flowed inside the stainless-steel tube for cooling. One module consisting of 54 pairs of legs can generate 1.5 V, 0.28 W, and steam simultaneously by installing in an instantaneous water heater. Power generation was carried out four times with intermediate cooling. Deterioration in the open-circuit voltage of the module was not observed after the fourth combustion. [source]

    General Flowshop Models: Job Dependent Capacities, Job Overlapping and Deterioration

    Gerd Finke
    Several extensions of the two-machine flowshop model that arise in industrial applications are considered. These modifications of the classical case concern buffer capacities that vary with the size of the part, and processing times that are variable and increase in situations of overlapping and long waiting periods between the different operations. [source]

    Site-Specific Deterioration of Trabecular Bone Architecture in Men and Women With Advancing Age

    Eva-Maria Lochmüller
    Abstract We tested the hypothesis that the age dependence of trabecular bone microstructure differs between men and women and is specific to skeletal site. Furthermore, we aimed to investigate the microstructural pattern of bone loss in aging. Microstructural properties of trabecular bone were measured in vitro in 75 men and 75 age-matched women (age, 52,99 yr) using ,CT. Trabecular bone samples were scanned at a 26-,m isotropic resolution at seven anatomical sites (i.e., distal radius, T10 and L2 vertebrae, iliac crest, femoral neck and trochanter, and calcaneus). DXA measurements were obtained at the distal radius and proximal femur and QCT was used at T12. No significant decrease in bone density or structure with age was found in men using ,CT, DXA, or QCT at any of the anatomical sites. In women, a significant age-dependent decrease in BV/TV was observed at most sites, which was strongest at the iliac crest and weakest at the distal radius. At most sites, the reduction in BV/TV was associated with an increase in structure model index, decrease in Tb.N, and an increase in Tb.Sp. Only in the calcaneus was it associated with a significant decrease in Tb.Th. In conclusion, a significant, site-specific correlation of trabecular bone microstructure with age was found in women but not in men of advanced age. The microstructural basis by which a loss of BV/TV occurs with age can vary between anatomical sites. [source]

    Deterioration of Organization in the First Minutes of Atrial Fibrillation: A Beat-to-Beat Analysis of Cycle Length and Wave Similarity

    Introduction: It has been recently suggested that many episodes of atrial fibrillation (AF) may be partially organized at the onset and thus more suitable for antitachycardia pacing therapy. Nevertheless, the time course of organization in the first minutes of AF has not been quantified yet. Methods and Results: Twenty episodes of paroxysmal AF were studied. Electrograms were recorded from the right atrium (RA), distal (CSd), and proximal coronary sinus (CSp). The time course of AF cycle length (AFCL) and the regularity of wave morphology (similarity index S) were beat-to-beat measured at each recording site during the first 7 minutes of AF. AFCL and S showed a decreasing trend after the onset of AF. AFCL decreased from 208 ± 31 to 171 ± 21 msec (P < 0.001), from 206 ± 40 to 169 ± 23 msec (P < 0.001) and from 190 ± 42 to 152 ± 18 msec (P < 0.05), respectively, in RA, CSd, and CSp. Similarly, the similarity index decreased in CSd from 0.37 ± 0.27 to 0.12 ± 0.09 (P < 0.01) and in RA from 0.40 ± 0.18 to 0.17 ± 0.16 (P < 0.001). The 80% of the decrease occurred during the first 3 minutes of the arrhythmia, while after this time both cycle length and similarity index did not change significantly anymore. Conversely, the electrical activity in CSp was highly disorganized (S = 0.05 ± 0.03) even in the first minute of AF, and no decreasing temporal trend was observed. Conclusion: Higher levels of organization and longer fibrillation intervals exist at the onset of AF. The degree of organization of the electrical activity decays within less than 3 minutes. Since antitachycardia pacing success rate increases with high levels of organization, these results suggest an early delivery of pacing treatment. [source]

    Nurse,client processes in mental health: recipients' perspectives

    An ethnonursing method was selected to explore and describe nursing support relationships, from the perspectives of recipients, within the mental health subculture. Data sources consisted of three semi-structured client interviews (n = 14) and field notes. When nurses were described as nice and friendly, and validated the client as a person by listening, three overlapping phases of development emerged from the data. These included: a glimmer of help, exploring and problem solving, and saying goodbye. When clients had negative experiences with nurses, they felt a lack of trust towards nurses and felt that their feelings were left unexplored. As a result, the relationships deteriorated. Deterioration began immediately in the first phase called withholding, and continued through the phases of avoiding and ignoring, and struggling with and making sense of. These findings raise healthcare providers' awareness about developing and deteriorating nurse,client relationships, and support the value of the therapeutic relationship as an instrument to restore and promote clients' health. [source]

    Performance monitoring during sleep inertia after a 1-h daytime nap

    Summary Performance monitoring is an essential function involved in the correction of errors. Deterioration of this function may result in serious accidents. This function is reflected in two event-related potential (ERP) components that occur after erroneous responses, specifically the error-related negativity/error negativity (ERN/Ne) and error positivity (Pe). The ERN/Ne is thought to be associated with error detection, while the Pe is thought to reflect motivational significance or recognition of errors. Using these ERP components, some studies have shown that sleepiness resulting from extended wakefulness may cause a decline in error-monitoring function. However, the effects of sleep inertia have not yet been explored. In this study, we examined the effects of sleep inertia immediately after a 1-h daytime nap on error-monitoring function as expressed through the ERN/Ne and Pe. Nine healthy young adults participated in two different experimental conditions (nap and rest). Participants performed the arrow-orientation task before and immediately after a 1-h nap or rest period. Immediately after the nap, participants reported an increased effort to perform the task and tended to estimate their performance as better, despite no objective difference in actual performance between the two conditions. ERN/Ne amplitude showed no difference between the conditions; however, the amplitude of the Pe was reduced following the nap. These results suggest that individuals can detect their own error responses, but the motivational significance ascribed to these errors might be diminished during the sleep inertia experienced after a 1-h nap. This decline might lead to overestimation of their performance. [source]

    Identification, molecular biotyping and ultrastructural studies of bacterial communities isolated from two damaged frescoes of St Damian's Monastery in Assisi,

    A. Radaelli
    Abstract Aim:, To investigate the composition of the microbial community in biodeterioration of two frescoes in St Damian's Monastery in Assisi. Methods and Results:, A total of 1292 colonies were isolated from the most deteriorated parts, analysed by microbiological, biomolecular and ultrastructural techniques, and taxonomically classified. Molecular biotyping of Staphylococcus cohnii colonies, one of the most prevalent bacterial species, showed a very restricted genome diversity while Bacillus licheniformis were very homogeneous by RFLP, tDNA-PCR and random-amplified polymorphic DNA. Electron microscopy confirmed heterogeneity of the bacterial population in the different sampling areas. Conclusions:, Several of the identified species are widespread in the soil or saprophytes of human skin. Although unable to demonstrate that they are involved in biodeterioration, they may represent trophic elements contributing to fungi-related chromatic alterations when adequate environmental conditions occur. Deterioration may in part be prevented or controlled by adequate air filtering or conditioning of the room. [source]

    Mild hypothermia inhibits IL-10 production in peripheral blood mononuclear cells

    T. Matsui
    Background:, Hypothermia is often associated with compromised host defenses and infections. Deterioration of immune functions related to hypothermia have been investigated, but the involvement of cytokines in host defense mechanisms and in infection remains unclear. Therefore, we determined whether mild hypothermia affects the production of several types of cytokines in peripheral blood mononuclear cells (PBMCs), and the balance between pro-inflammatory and anti-inflammatory states. Methods:, PBMCs obtained from 12 healthy humans were cultured with phytohemagglutinin (PHA) in normothermic (37°C: control) or hypothermic (33°C) conditions for 24 h. The production levels of tumor necrosis factor (TNF)-,, the interleukins (ILs) IL-6, IL-8 and IL-10, and interferon (IFN)-, in the culture supernatants were measured by means of enzyme-linked immunosorbent assay (ELISA). Results:, Under hypothermic conditions (33°C), PHA-induced production of IL-10 and IFN-, in PBMCs was significantly lower, by 34% and 84%, respectively, when compared with controls, while production of TNF-,, IL-6 and IL-8 did not change. The magnitude of reduction of IL-10 in hypothermic conditions resulted in IL-10/pro-inflammatory cytokine ratios decreasing to approximately 30,45% of those of controls. Conclusions:, The present study clearly demonstrates that mild hypothermia (33°C) inhibits IL-10 and IFN-, production in cultured PBMCs. The profound inhibition of IL-10 and the pro-inflammatory reaction-dominated state induced suggests that the host defense mechanism against secondary infection may be maintained rather than inhibited in hypothermia. Thus, the reduction of IL-10 could be an important characteristic of immune responses in mild hypothermia. [source]

    Patient with late-onset Wilson's disease: Deterioration with penicillamine

    MOVEMENT DISORDERS, Issue 2 2007
    Melis Sohtaoglu MD

    Deterioration in mechanical properties of glass fiber-reinforced nylon 6,6 composites by aqueous calcium chloride mixture solutions

    POLYMER COMPOSITES, Issue 4 2009
    D. Manjula Dhevi
    In this article, nylon 6,6 (NY66) and glass fiber-(30 wt%) reinforced NY66 (GFNY66) specimens were immersed in various aqueous calcium chloride (aq. CaCl2) mixture solutions at different thermal conditions for varying intervals of time, and analyzed using attenuated total reflection-infrared (ATR-IR) spectroscopy, inductively coupled plasma (ICP), energy dispersive X-ray (EDX), gel permeation chromatography (GPC), and mechanical studies. ICP data revealed increasing concentration of absorbed Ca2+ ions with increasing immersion time resulting in disruption of intra- and intermolecular H-bonding as confirmed using ATR-IR results. From EDX data, the ratio of Ca2+ and Cl, ions absorbed by NY66 was calculated and found to follow its stoichiometric equivalence. GPC data exhibited less reduction in Mn and Mw for aq. CaCl2 -treated NY66 specimens suggesting the absence of any significant chemical degradation, but the occurrence of only physical changes involving H-bond breakage and the formation of new CO···Ca2+ dative bond in NY66 matrix. The mechanical properties of GFNY66 samples treated with various types of aq. CaCl2 solutions exhibited pronounced deterioration, possibly due to the interfacial failure between glass fiber and NY66 matrix. The results obtained from this study were quite useful toward understanding the degradation mechanism in NY66 and GFNY66 caused by various aq. CaCl2 mixture solutions, and will be helpful in improving the mechanical properties of recycled NY66. POLYM. COMPOS., 2009. © 2008 Society of Plastics Engineers [source]

    Deterioration of intelligence in methamphetamine-induced psychosis: Comparison with alcohol dependence on WAIS-III

    Shih-Ku Lin md
    Aims:, Long-term use of methamphetamine could induce psychosis, but consequences with regards to intelligence have seldom been investigated. Long-term use of alcohol could also result in intellectual deterioration. Methods:, The IQ of 34 methamphetamine-induced psychosis (MIP) patients (age, 28.7 ± 6.1 years) and 34 alcohol-dependent (AD) patients (age, 40.7 ± 7.3 years) was compared using the Chinese version of the Wechsler Adult Intelligence Scale,Third Edition (WAIS-III). Results:, The average full-scale IQ, verbal IQ, performance IQ, verbal comprehension index, working memory index, perceptual organization index, and processing speed index was 82.3 ± 10.8, 84.3 ± 11.9, 81.9 ± 12.1, 85.5 ± 11.9, 84.7 ± 12.5, 85.4 ± 13.6, and 78.5 ± 12.7 in MIP patients and 90.5 ± 12.0, 95.2 ± 11.3, 86.0 ± 13.7, 95.5 ± 11.0, 87.1 ± 14.5, 96.2 ± 13.1, and 84.5 ± 15.0 in AD patients, respectively. There were six MIP patients (17.6%) whose full-scale IQ was <70 and 13 (38.2%) whose full-scale IQ was <85 and >70, while one AD patient had a full-scale IQ <70 (2.9%) and 10 (22%) had full-scale IQ <85 and >70. Conclusions:, Long-term use of methamphetamine can result not only in psychosis, but also in mentality deterioration. Intelligence deterioration is more severe in clinical MIP patients than AD patients. Assessment of the mentality of MIP patients is suggested to help with the implementation of rehabilitative programs for these patients. [source]

    Efficacy and safety of donepezil in patients with dementia with Lewy bodies: Preliminary findings from an open-label study

    Abstract, The objectives of the present study were first to determine the feasibility of conducting a randomized clinical trial of 5 mg/day donepezil in patients with mild to moderate dementia with Lewy bodies (DLB) and second, to obtain preliminary data of possible intervention effects. Twelve patients with probable DLB were evaluated at weeks 4, 8, and 12 using modified Neuropsychiatric Inventory (NPI) with an extra domain to additionally evaluate fluctuation in cognitive functions (NPI-11); the Japanese version of Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-J cog); and the Unified Parkinson's Disease Rating Scale (UPDRS). The NPI-11 scores were significantly improved at weeks 8 and 12 compared with baseline. Despite a significant improvement in ADAS-J-cog at week 4, no more improvement was noted thereafter. Deterioration was not noted in UPDRS scores. Donepezil is expected to be therapeutically useful and safe in treating DLB patients, indicating marked improvements in behavioral and psychological symptoms of dementia (BPSD) rather than in cognitive deficit, without deteriorating parkinsonism. [source]

    Deterioration of the Pharyngo-UES Contractile Reflex in the Elderly ,

    THE LARYNGOSCOPE, Issue 9 2000
    Junlong Ren MD
    Abstract Objectives/Hypothesis Deterioration of aerodigestive tract reflexes such as the esophagoglottal and pharyngoglottal closure reflexes and pharyngeal swallow has been documented in the elderly. However, the effect of aging on the contractile response of the upper esophageal sphincter (UES) to pharyngeal water stimulation has not been studied. The aim of this study was to characterize the pharyngo-UES reflex in the healthy elderly. Methods We studied nine healthy elderly (77 ± 1 y [SD]; four men, five women) and nine healthy young volunteers (26 ± 2 y [SD]; four men, five women). A UES sleeve sensor was used to measure the pressure. We tested pharyngeal stimulation induced by rapid pulse and slow continuous injection of water. Results The volume of water required to stimulate the pharyngo-UES contractile reflex by rapid pulse injection in the elderly (0.5 ± 34 0.1 mL) was significantly higher than that in the young (0.1 ± 0.02 mL) (P < .05). In contrast to young subjects, there was no pressure increase in resting UES pressure observed in the elderly for continuous pharyngeal water infusion. In both young and elderly, the threshold volume for the pharyngo-UES contractile reflex was significantly lower than that for pharyngeal swallows. Conclusions The pharyngo-UES contractile reflex deteriorates with aging. This deterioration is primarily due to abnormalities of the afferent limb of the reflex. [source]

    Banff '09 Meeting Report: Antibody Mediated Graft Deterioration and Implementation of Banff Working Groups

    B. Sis
    The 10th Banff Conference on Allograft Pathology was held in Banff, Canada from August 9 to 14, 2009. A total of 263 transplant clinicians, pathologists, surgeons, immunologists and researchers discussed several aspects of solid organ transplants with a special focus on antibody mediated graft injury. The willingness of the Banff process to adapt continuously in response to new research and improve potential weaknesses, led to the implementation of six working groups on the following areas: isolated v-lesion, fibrosis scoring, glomerular lesions, molecular pathology, polyomavirus nephropathy and quality assurance. Banff working groups will conduct multicenter trials to evaluate the clinical relevance, practical feasibility and reproducibility of potential changes to the Banff classification. There were also sessions on quality improvement in biopsy reading and utilization of virtual microscopy for maintaining competence in transplant biopsy interpretation. In addition, compelling molecular research data led to the discussion of incorporation of omics-technologies and discovery of new tissue markers with the goal of combining histopathology and molecular parameters within the Banff working classification in the near future. [source]

    Epithelial to Mesenchymal Transition During Late Deterioration of Human Kidney Transplants: The Role of Tubular Cells in Fibrogenesis

    Attapong Vongwiwatana
    The hallmark of failing renal transplants is tubular atrophy and interstitial fibrosis (TA/IF). Injury to tubular epithelial cells (TEC) could contribute to fibrogenesis via epithelial,mesenchymal transition (EMT). We examined the features of EMT in renal transplants that developed TA/IF. Biopsies from 10 allograft kidneys with impaired function and TA/IF and 10 biopsies from transplants with stable function were compared to their implantation biopsies. Relative to implantation biopsies, TEC in TA/IF kidneys showed loss of epithelial markers (E-cadherin, cytokeratin) with altered distribution. Some TEC also showed new cytoplasmic expression of mesenchymal markers vimentin, S100A4, and alpha smooth muscle actin (,-SMA) and collagen synthesis marker heat shock protein (HSP-47), both in deteriorating and atrophic tubules. Double immunostaining showed coexpression of cytokeratin and vimentin, S100A4 and HSP-47, indicating intermediate stages of EMT in TA/IF. These changes were absent or much less in transplants with stable function. EMT features in the TA/IF group correlated with serum creatinine (vimentin, S100A4, HSP-47), history of T-cell-mediated rejection (cytokeratin, S100A4) and proteinuria (cytokeratin). These findings support a model in which the TEC damage induces loss of epithelial features and expression of fibroblast features, as a common pathway of deterioration by either immunologic or nonimmunologic processes. [source]

    Call for Revolution: A New Approach to Describing Allograft Deterioration

    Philip F. Halloran
    I propose a set of definable entities in the renal transplant course, eliminating the need for the term ,chronic rejection'. The status of a renal transplant can be defined by the presence and extent of rejection (T-cell-mediated or antibody-mediated); allograft nephropathy (parenchymal atrophy, fibrosis, and fibrous intimal thickening in arteries); transplant glomerulopathy; specific diseases; and factors which could accelerate progression. The level of function and the slope of the loss of function should be separately determined. This approach can be applied both in research and in clinical practice, and can be adapted to other organ transplants. [source]

    Drug-induced methaemoglobinaemia following elective coronary artery bypass grafting

    ANAESTHESIA, Issue 7 2007
    A. Choi
    Summary Dapsone can alter the oxygen carrying capacity of haemoglobin. Some patients are more susceptible to these effects because of genetic factors, comorbidities or peri-operative factors such as anaemia. We present a 57-year-old lady who underwent elective coronary artery bypass grafting. Deterioration in neurological and respiratory condition prompted a review of her drug treatment. A combination of long-term dapsone therapy, co-existing cardiac and respiratory disease, postoperative anaemia and renal impairment contributed to her decompensation, despite a relatively low level of methaemoglobin. Successful management included stopping dapsone therapy, supportive care and administration of ascorbic acid. [source]

    Development of the Baylor Gyro Permanently Implantable Centrifugal Blood Pump as a Biventricular Assist Device

    ARTIFICIAL ORGANS, Issue 9 2001
    Kenji Nonaka
    Abstract: The Baylor Gyro permanently implantable centrifugal blood pump (Gyro PI pump) has been under development since 1995 at Baylor College of Medicine. Excellent results were achieved as a left ventricular assist device (LVAD) with survival up to 284 days. Based on these results, we are now focusing on the development of a biventricular assist device (BVAD) system, which requires 2 pumps to be implanted simultaneously in the preperitoneal space. Our hypothesis was that the Gyro PI pump would be an appropriate device for an implantable BVAD system. The Gyro PI 700 pump is fabricated from titanium alloy and has a 25 ml priming volume, pump weight of 204 g, height of 45 mm, and pump diameter of 65 mm. This pump can provide 5 L/min against 100 mm Hg at 2,000 rpm. In this study, 6 half-Dexter healthy calves have been used as the experimental model. The right pump was applied between the infundibular of the right ventricle and the main pulmonary artery. The left pump was applied between the apex of the left ventricle and the thoracic descending aorta. As for anticoagulation, heparin was administered at the first postoperative week and then converted to warfarin sodium from the second week after surgery. Both pump flow rates were controlled maintaining a pulmonary arterial flow of less than 160 ml/kg/min for the sake of avoidance of pulmonary congestion. Blood sampling was done to assess visceral organ function, and the data regarding pump performance were collected. After encountering the endpoint, which the study could not keep for any reasons, necropsy and histopathological examinations were performed. The first 2 cases were terminated within 1 week. Deterioration of the pump flow due to suction phenomenon was recognized in both cases. To avoid the suction phenomenon, a flexible conduit attached on the inlet conduit was designed and implanted. After using the flexible inflow conduit, the required power and the rotational speed were reduced. Furthermore, the suction phenomenon was not observed except for 1 case. There was no deterioration regarding visceral organ function, and pulmonary function was maintained within normal range except for 1 case. Even though the experimental animal survived up to 45 days with the flexible inflow conduit, an increase in power consumption due to thrombus formation behind the impeller became a problem. Lower rotational speed, which was probably produced by the effectiveness of the flexible inflow conduit, was speculated to be one of the reasons. And the minimum range of rotational speed was 1,950 rpm in these 6 BVAD cases and the previous 3 cases of LVAD. In conclusion, 6 cases of BVAD implantation were performed as in vivo animal studies and were observed up to 45 days. The flexible inflow conduit was applied in 4 of 6 cases, and it was effective in avoiding a suction phenomenon. The proper rotational speed of the Gyro PI 700 pump was detected from the viewpoint of antithrombogenicity, which is more than 1,950 rpm. [source]

    Deterioration in cord blood gas status during the second stage of labour is more rapid in the second twin than in the first twin

    Tak-Yeung Leung
    Objective To compare in twin pregnancy the rate of deterioration in umbilical blood gas status during the second stage of labour, and to investigate whether the duration of the first twin's delivery has any effect on the blood gas status of the second twin. Design A retrospective study. Setting Department of Obstetrics and Gynaecology in a university teaching hospital. Population Twin pregnancies with both of the twins delivered by normal cephalic vaginal mode, at or beyond 34 weeks of gestation, over a period of seven years. Twins with any maternal or fetal complications including discordant growth, intrauterine growth restriction, intrauterine death, fetal malformations, fetal distress, pre-eclampsia and diabetes were excluded. Methods The first twins' second stage was defined as from the start of maternal pushing to his/her delivery, while the second twins' second stage started after the delivery of the first twin and ended by his/her delivery. The total duration of the second stage was the sum of the above two intervals. The correlations between the first twins' umbilical cord blood gas parameters and the duration of their own second stage, the second twins' umbilical cord blood gas parameters and the duration of their own second stage, as well as that of the total second stage, were studied. Main outcome measures The changes of umbilical arterial pH of each twin with the duration of the corresponding second stage of labour, and the difference among them. Results A total of 51 cases were reviewed. The median gestation at delivery was 37 weeks. The median duration of first twins' second stage was 10 minutes (range 1,75) while that of the second twins' was 10 minutes (range 3,26). The first twins' second stage was inversely correlated with their arterial pH, venous pH and base excess [BE] (P < 0.01). Both the second twins' second stage and the total second stage were inversely correlated with both of their arterial and venous pH and BE (P < 0.01). However, further multiple regression analysis suggested that the correlation of the total second stage with the second twins' cord blood parameters could be solely explained by their own second stage. The rate of reduction in the second twins' arterial pH was 4.95 × 10,3 per minute, and was significantly faster than that of the first twins', which was 1.55 × 10,3 per minute (P < 0.05). Conclusions During normal vaginal delivery, the umbilical cord blood gas status of both the first and the second twins deteriorated with the duration of their corresponding second stages, but the effects are greater in the latter. Furthermore, the duration of the first twins' second stage does not affect the blood gas status of the second twins'. These observations support the postulation of a diminished uteroplacental exchange function after the delivery of the first twin. Close monitoring and expeditious delivery of the second twins are important. [source]

    Health-related quality of life during neoadjuvant treatment and surgery for localized esophageal carcinoma

    CANCER, Issue 9 2005
    Jane M. Blazeby B.Sc., M.D.
    Abstract BACKGROUND Esophagectomy has a negative influence on health-related quality of life (HRQL) during the first postoperative year, but it is not known how chemotherapy or chemoradiotherapy treatment before surgery affects HRQL. The current study examined HRQL during preoperative chemotherapy/chemoradiotherapy treatment and compared postoperative recovery of HRQL in patients undergoing combined treatment with patients undergoing surgery alone. METHODS One hundred three patients completed standardized HRQL measures before and during neoadjuvant treatment and before and after surgery. Mean HRQL scores were calculated and preoperative scores were used to model postoperative ratings using linear regression. RESULTS Deterioration in most aspects of HRQL occurred during preoperative chemotherapy. Patients proceeding to concomitant radiotherapy further deteriorated with specific problems with reflux symptoms and role function (difference between means >15, P < 0.01). After neoadjuvant treatment, but before surgery, HRQL returned to baseline levels. Six weeks after surgery, patients reported marked reductions in physical, role, and social function (difference between means > 30, P < 0.01) and increase in fatigue, nausea and emesis, pain, dyspnea, appetite loss, and coughing (difference between means > 15, P < 0.01). Recovery of HRQL was not hampered by preoperative treatment, and fewer problems with postoperative nausea, emesis, and dysphagia were reported by patients who had undergone neoadjuvant treatment compared with patients who had undergone surgery alone. CONCLUSIONS Preoperative chemotherapy or chemoradiotherapy had a negative impact on HRQL that was restored in patients proceeding to surgery. Recovery of HRQL after esophagectomy was not impaired by neoadjuvant treatment. These results supported the use of neoadjuvant treatment before surgery. Cancer 2005. © 2005 American Cancer Society. [source]

    Progress of visual dysfunction in Parkinson's disease

    T. Müller
    Studies on progression of Parkinson's disease (PD) mainly focus on the nigrostriatal dopaminergic decline, but not on the visual system. We determined progression of (i) disturbed color vision, assessed with the Farnsworth,Munsell 100 Hue test (FMT) and (ii) intensity of PD in 18 patients. Significant differences occurred between (i) initial FMT error scores and follow-up results 3 years later (P=0.002) and analogously (ii) scored intensity of PD (P=0.002). A relation between computed differences of FMT error scores and rated activities of daily living appeared. Deterioration of color vision progresses in PD. [source]

    Five-year incidence of visual impairment and blindness in older Icelanders: the Reykjavik Eye Study

    Elin Gunnlaugsdottir
    Abstract. Purpose:, This study examined age, sex and cause-specific 5-year incidence of visual impairment and blindness in a middle-aged and elderly Icelandic population. Methods:, The study cohort consisted of a population-based, random sample of citizens aged , 50 years. Of 1379 eligible subjects, 1045 underwent a baseline examination in 1996; 846 of the 958 survivors (88.2%) underwent a 5-year follow-up examination in 2001. All participants underwent an extensive ophthalmological examination including best corrected visual acuity (BCVA) using a Snellen chart. We used World Health Organization (WHO) criteria, which define visual impairment as BCVA in the better eye of < 6/18 and , 3/60 and blindness as BCVA in the better eye of < 3/60. We also used US criteria, which consider BCVA of < 6/12 and > 6/60 in the better eye to represent visual impairment and BCVA of , 6/60 in the better eye to represent blindness. The causes of incident visual loss in either eye were determined. Deterioration or improvement in vision were defined as a loss or gain of , 2 Snellen lines. Results:, According to WHO criteria, 5-year incidence of bilateral visual impairment and blindness were 1.07% (95% confidence interval [CI] 0.37,1.76) and 0.35% (95% CI 0.00,0.76), respectively. Using US criteria, equivalent incidence of bilateral visual impairment and blindness were 3.49% (95% CI 2.24,4.74) and 0.95% (95% CI 0.29,1.60), respectively. Age-related macular degeneration and cataract were the major causes of incident visual impairment and blindness. Conclusions:, Incidences of visual impairment and blindness increased significantly with age. Age-related macular degeneration, present in 75% of affected persons, was the most common cause of 5-year incident legal blindness in this middle-aged and elderly Icelandic population. [source]

    Bird evolution in the Eocene: climate change in Europe and a Danish fossil fauna

    BIOLOGICAL REVIEWS, Issue 4 2006
    Bent E. K. Lindow
    ABSTRACT The pattern of the evolutionary radiation of modern birds (Neornithes) has been debated for more than 10 years. However, the early fossil record of birds from the Paleogene, in particular, the Lower Eocene, has only recently begun to be used in a phylogenetic context to address the dynamics of this major vertebrate radiation. The Cretaceous-Paleogene (K-P) extinction event dominates our understanding of early modern bird evolution, but climate change throughout the Eocene is known to have also played a major role. The Paleocene and Lower Eocene was a time of avian diversification as a result of favourable global climatic conditions. Deteriorations in climate beginning in the Middle Eocene appear to be responsible for the demise of previously widespread avian lineages like Lithornithiformes and Gastornithidae. Other groups, such as Galliformes display replacement of some lineages by others, probably related to adaptations to a drier climate. Finally, the combination of slowly deteriorating climatic conditions from the Middle Eocene onwards, appears to have slowed the evolutionary rate in Europe, as avian faunas did not differentiate markedly until the Oligocene. Taking biotic factors in tandem with the known Paleogene fossil record of Neornithes has recently begun to illuminate this evolutionary event. Well-preserved fossil taxa are required in combination with ever-improving phylogenetic hypotheses for the interrelationships of modern birds founded on morphological characters. One key avifauna of this age, synthesised for the first time herein, is the Lower Eocene Fur Formation of Denmark. The Fur birds represent some of the best preserved (often in three dimensions and with soft tissues) known fossil records for major clades of modern birds. Clear phylogenetic assessment of these fossils will prove critical for future calibration of the neornithine evolutionary timescale. Some early diverging clades were clearly present in the Paleocene as evidenced directly by new fossil material alongside the phylogenetically constrained Lower Eocene taxa. A later Oligocene radiation of clades other than Passeriformes is not supported by available fossil data. [source]

    Continuing Progressive Deterioration of the Environment in the Aral Sea Region: Disastrous Effects on Mother and Child Health

    ACTA PAEDIATRICA, Issue 5 2001
    O Ataniyazova
    Scientists, non-governmental experts (NGOs) and governmental officials from the Central Asian Republics and an international group of invited scientists and NGO representatives participated in a workshop on the disastrous health problems in the Aral Sea Region. Various serious problems were reported in more than 20 presentations. Particular emphasis was put on the way in which adverse environmental factors such as contaminated water and food have contributed to the deterioration of human health, particularly that of mothers and children. Conclusion: There is an urgent request that the international community assists local scientists to develop programmes to improve the health of the population in the Aral Sea Region. [source]