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Early Indication (early + indication)
Selected AbstractsHeart Rate Variability in Emergency Department Patients with SepsisACADEMIC EMERGENCY MEDICINE, Issue 7 2002Douglas Barnaby MD Abstract Objective: To test the hypothesis that heart rate variability (HRV) can provide an early indication of illness severity among patients presenting to the emergency department (ED) with sepsis. Methods: The authors enrolled a convenience sample of 15 ED patients meeting the American College of Chest Physicians/Society of Critical Care Medicine criteria for sepsis. Each patient had continuous Holter monitoring performed in the ED. Acute Physiology and Chronic Health II (APACHE II) and Sequential Organ Failure (SOFA) scores were calculated for the day of presentation. Holter tapes obtained in the ED were analyzed off-line to calculate HRV variables for the 5-minute segment with the least artifact and non-sinus beats. These variables were correlated with APACHE II and SOFA scores. Results: LFnu (normalized low-frequency power), an assessment of the relative sympathetic contribution to overall HRV, was correlated with increased illness severity as calculated using APACHE II (r = -0.67, r2= 0.43) and SOFA (r = -0.80, r2= 0.64) scores. LF/HF ratio (low-frequency/high-frequency ratio), a measure of sympathovagal balance, was correlated with the SOFA score [r = -0.54 (95% CI = -0.83 to -0.01), r2= 0.29]. All five patients who required critical care monitoring or ventilatory support or who died during the first 5 days of their hospitalization had LFnu values below 0.5 and LF/HF ratios less than 1.0. None of the patients with measurements greater than these threshold values died or required these interventions during the five days following admission. Conclusions: A single variable, LFnu, which reflects sympathetic modulation of heart rate, accounted for 40-60% of the variance in illness severity scores among patients presenting to the ED with sepsis. HRV, as reflected in LFnu and the LF/HF ratio and measured with a single brief (5-minute) period of monitoring while in the ED, may provide the emergency physician with a readily available, noninvasive, early marker of illness severity. The threshold effect of LFnu and LF/HF in the prediction of early clinical deterioration was an unexpected finding and should be regarded as hypothesis-generating, pending further study. [source] Fibroblast cell attachment and growth on nanoengineered sculptured thin filmsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2007M. C. Demirel Abstract Nanoengineered parylene-C sculptured thin films (STFs) are deposited on glass and silicon substrates using a direct one-step growth technique. The deposited STFs support fibroblast cell attachment and proliferation in vitro, which is an early indication of biocompatibility and bioactivity of this emerging class of biomaterials. Surface modification of endoprostheses of the small joints of the hand, which heal with fibrous stabilization, may be greatly enhanced by such nanoengineered biomaterials. © 2006 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2006 [source] Astrocyte metabolism is disturbed in the early development of experimental hydrocephalusJOURNAL OF NEUROCHEMISTRY, Issue 1 2003Daniel Kondziella Abstract The proper diagnosis of the arrested or the progressive form of hydrocephalus has a critical impact on treatment, but remains difficult. The assessment of early changes in cerebral metabolism might help in the development of adequate non-invasive diagnostic tools. This study examined the alterations in label incorporation in neurotransmitter amino acids and other compounds in kaolin-induced progressive hydrocephalus in rats by means of magnetic resonance spectroscopy (MRS) combined with the administration of [1- 13C]glucose and [1,2- 13C]acetate. Some 2, 4 and 6 weeks after kaolin injection into the cisterna magna, cerebrum, brainstem and cerebellum were dissected. Interestingly, labelling of most amino acids derived from [1- 13C]glucose showed no alterations, whereas labelling from [1,2- 13C]acetate was affected. Two weeks after induction of hydrocephalus the taurine concentration was decreased, whereas the concentration of [1,2- 13C]lactate was increased in the cerebrum and that of [1,2- 13C]GABA in the brainstem. Furthermore, labelling from [1,2- 13C]acetate was significantly decreased in [4,5- 13C]glutamate, [1,2- 13C]glutamate and [1,2- 13C]GABA in cerebrum from 4 weeks after hydrocephalus induction. The concentration of N -acetylaspartate, a neuronal marker, was unchanged. However, labelling of the acetyl group from [1- 13C]glucose was decreased in cerebellum and brainstem at 6 weeks after the induction of hydrocephalus. As glucose is metabolized predominately by neurones, whereas acetate is exclusively taken up by astrocytes, these results indicate that mostly astrocytic, and only later neuronal, metabolism is disturbed in the kaolin model of hydrocephalus. If verified in patients using in vivo MRS, impaired astrocyte metabolism might serve as an early indication for operative treatment. [source] Safety of pyrethroid-treated mosquito netsMEDICAL AND VETERINARY ENTOMOLOGY, Issue 1 2000M. Zaim Summary The use of insecticide treated nets (ITNs) for personal protection against malaria vector Anopheles mosquitoes (Diptera: Culicidae) has become popular during the past decade. With the precautions outlined in this paper, field use of pyrethroids , at concentrations recommended for treatment of mosquito nets , poses little or no hazard to people treating the nets or to users of the treated nets. With frequent exposure to low concentrations of pyrethroids, the risk of toxicity of any kind is remote. Pyrethroids entering the systemic circulation are rapidly metabolized to much less toxic metabolites. Toxicologically, pyrethroids have a useful characteristic , the production of skin paraesthesia , which gives an early indication of exposure. This reversible symptom of exposure is due to transient stimulation of peripheral sensory nerves and not a toxic effect. In the retail market, for home use, the provision of proper packaging and labelling, with clear instructions on safe and effective use of the product are most important. Because many domestic users of pyrethroid ,home treatment kits' for ITNs may not be fully literate, it is essential that ,instructions for use' should be portrayed via pictograms with supporting text in appropriate local language(s). [source] Monitoring sedation in the critically ill childANAESTHESIA, Issue 5 2010A. Lamas Summary Sedation is an essential part of the management of the critically ill child, and its monitoring must be individualised and continuous in order to adjust drug doses according to the clinical state. There is no ideal method for evaluating sedation in the critically ill child. Haemodynamic variables have not been found to be useful. Clinical scales are useful when sedation is moderate, but are limited by their subjective nature, the use of stimuli, and the impossibility of evaluating profoundly sedated patients or those receiving neuromuscular blocking drugs; in addition, many of these scales have not been evaluated in children. The COMFORT scale is the most appropriate, as it was designed and validated for critically ill children requiring mechanical ventilation. Electroencephalography-derived methods permit continuous monitoring, provide an early indication of changes in the level of sedation, and facilitate a rapid adjustment of medication. However, these methods were designed and validated for patients under anaesthesia and their results cannot be fully extrapolated to the critically ill patient; in addition, some of them have not been validated in small children and there is still little experience in critically ill children. The main indications for the use of these methods are in patients with deep sedation and/or neuromuscular blockade. The bispectral index is the most widely used method at the present time. Analysis and comparison of the efficacy of the different methods for evaluating sedation in the critically ill child is required. [source] Real-time Polymerase Chain Reaction to Follow the Response of Muscle to TrainingARTIFICIAL ORGANS, Issue 8 2008Lauren M. Moore Abstract:, The adaptive response of muscle to changes in activity or loading can take many weeks. Changes in the levels of RNA within a muscle fiber can give an early indication of the nature of the response of that fiber to changes in activity or loading. We have designed a new primer set for quantitative polymerase chain reaction (PCR) that will allow us to follow these early transcriptional changes in rat muscle, and have shown that analysis can be performed by standard techniques on as little as 5 mg of muscle, an amount that can be obtained by needle biopsy. [source] Child behaviour and adult personality: comparisons between criminality groups in Finland and SwedenCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2000Professor Lea Pulkkinen Background; Lately there has been an increasing interest in whether personality traits are associated with criminal behaviour in male and female subjects. Criminality and alcohol abuse are often associated. Delinquent adolescents are impulsive and danger seeking. Childhood aggression may be a precursor of adult criminality. Method Using longitudinal data, adult personality and childhood behaviours were examined for groups of non-criminals and criminals of Finnish (n = 268) and Swedish (n + 169) samples, and crime groups were compared in the two cultures. Karolinska Scales of Personality (KSP) were given at adult age and the participants had been observed and rated by their teachers in respect of behaviour in childhood (at age 8 years and 13 years, respectively). Results Male offenders with alcohol problems (Finnish and Swedish) had significantly higher scores on psychopathy-related personality traits in adulthood than other subgroups, as indicated by higher impulsivity, muscular tension and lower socialization. They also displayed higher scores on teacher-rated aggressiveness in childhood than the non-criminal groups. The female subgroup displaying criminal activity was small. It did not differ significantly from non-offenders in adult personality characteristics. Female offenders, however, showed early indications of lower sociability (in Finland) and higher aggressiveness and disharmony in childhood than non-offenders (in Sweden). Discussion The study suggests that early problem behaviours are precursors of subsequent criminal activity in at least two cultures. The results emphasize the importance of longitudinal research programmes. Copyright © 2000 Whurr Publishers Ltd. [source] NGO Initiatives in Risk Reduction: An OverviewDISASTERS, Issue 3 2001Charlotte Benson NGOs appear to be well placed to play a significant role in natural disaster mitigation and preparedness (DMP), working, as they do, with poorer and marginalised groups in society. However, there is little information on the scale or nature of NGO DMP activities. This paper reports the findings of a study seeking to address that gap. It confirms that NGOs are involved in a diverse range of DMP activities but that a number of them are not labelled as such. Moreover, evidence of the demonstrable quality and benefits of DMP involvement is poor. The paper concludes that a number of problems need to be overcome before DMP can be satisfactorily mainstreamed into NGO development and post-disaster rehabilitation programmes. However, there are some early indications of momentum for change. [source] Perspective: Assessing the Clinical Utility of Serum CTX in Postmenopausal Osteoporosis and Its Use in Predicting Risk of Osteonecrosis of the Jaw,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2009Sanford Baim Abstract Bone turnover markers (BTMs) have become increasingly important in the management of postmenopausal osteoporosis (PMO). In bisphosphonate-treated women with PMO, BTMs can provide early indications of treatment efficacy, are predictors of BMD response and fracture risk reduction, and are potentially useful for monitoring patient compliance. The bone resorption marker serum C-telopeptide cross-link of type 1 collagen (sCTX) has shown high sensitivity and specificity for the detection of increased bone resorption. Recently, sCTX has been singled out as a potential indicator of risk of osteonecrosis of the jaw (ONJ) in patients receiving oral bisphosphonates who require oral surgery. However, whether BTMs are capable of predicting ONJ risk and whether sCTX is usable for this purpose are controversial questions. This article presents an overview of the current literature regarding critical issues affecting the clinical utility of BTMs (including variability and reference ranges) and the current applications of BTMs in PMO management, with a focus on sCTX. Last, the appropriateness of using sCTX to predict ONJ risk in women receiving oral bisphosphonates for PMO is evaluated. [source] Behavioral and Biological Indicators of Impulsivity in the Development of Alcohol Use, Problems, and DisordersALCOHOLISM, Issue 8 2010C.W. Lejuez Alcohol use disorders (AUDs) are a devastating public health problem. The construct of impulsivity is biologically based and heritable, and its various dimensions are relevant for understanding alcohol use. The goal of the current manuscript is to review recent behavioral and biological research examining various dimensions of impulsivity and their relation to AUDs from risk for initial use through dependence and relapse. Moreover, we also highlight key psychological variables including affective processes as they relate to current use and early indications of alcohol problems, as well as psychopathology, violence, and aggression in relation to AUDs. Each section includes a critical summary and we conclude the review with future directions focused on issues relevant to measurement, causality, and intervention. Throughout the review, we attempt to be as specific as possible about the dimensions of impulsivity being referenced, while attempting to draw parallels and highlighting differences as the existing literature allows. [source] Storm prediction over Europe using the ECMWF Ensemble Prediction SystemMETEOROLOGICAL APPLICATIONS, Issue 3 2002Roberto Buizza Three severe storms caused great damage in Europe in December 1999. The first storm hit Denmark and Germany on 3 and 4 December, and the other two storms crossed France and Germany on 26 and 28 December. In this study, the performance of the Ensemble Prediction System (EPS) at the European Centre for Medium-Range Weather Forecast (ECMWF) in predicting these intense storms is investigated. Results indicate that the EPS gave early indications of possible severe storm occurrence, and was especially useful when the deterministic TL319L60 forecasts issued on successive days were highly inconsistent. These results indicate that the EPS is a valuable tool for assessing quantitatively the risk of severe weather and issuing early warnings of possible disruptions. The impact of an increase of the ensemble system horizontal resolution (TL255 integration from a TL511 analysis instead of the operational TL159 integration from a TL319 analysis) on the system performance is also investigated. Results show that the resolution increase enhances the ensemble performance in predicting the position and the intensity of intense storms. Copyright © 2002 Royal Meteorological Society. [source] Dynamics of a protected black rhino (Diceros bicornis) population: Pilanesberg National Park, South AfricaANIMAL CONSERVATION, Issue 3 2005Halszka Hrabar Achieving maximum productivity in remnant populations of black rhinoceros is crucial to the persistence of this species. It was, therefore, investigated whether the black rhino population of Pilanesberg National Park had become regulated by resource limitation 22 years after introduction in 1979. Inter-calving intervals (which are not restricted to yearly time increments, due to asynchronous reproduction) decreased with an increase in rainfall, while the percentage of male calves born increased with increasing rainfall. The percentage of reproductive cows achieving maternal success increased with increasing density until 0.085 rhinos/km2, after which it decreased. This positive relationship at low densities is largely due to changes in the female age structure and the adult female/male ratio. The age at first calving tended to increase with increasing density, while mortality was not related to rainfall or density. It is concluded that the Pilanesberg black rhino population is showing the first signs of density dependence. It is proposed that black rhino conservators should monitor the percentage of cows achieving maternal success to detect early indications of density dependent resource limitation and use this as a criteria for decisions regarding metapopulation management. [source] | |||||||||||||