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Increased Recognition (increased + recognition)
Selected AbstractsNew insights into autoimmune liver diseasesHEPATOLOGY RESEARCH, Issue 8 2008Teru Kumagi Autoinflammatory liver disease represents an important aspect of global hepatological practice. The three principal disease divisions recognized are autoimmune hepatitis, primary sclerosing cholangitis and primary biliary cirrhosis. Largely, but not exclusively, these diseases are considered to be autoimmune in origin. Increased recognition of outlier and overlap syndromes, changes in presentation and natural history, as well as the increased awareness of IgG4-associated sclerosing cholangitis, all highlight the limitations of the classic terminology. New insights continue to improve the care given to patients, and have arisen from carefully conducted clinical studies, therapeutic trials, as well as genetic and laboratory investigations. The challenges remain to treat patients before liver injury becomes permanent and to prevent the development of organ failure. [source] Flat colonic adenomas in Malaysia: Fact or fancy?JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 6 2003SHANMUGARAJAH RAJENDRA Abstract Background: Some two-thirds of colorectal carcinomas arise from adenomatous polyps, and as such, screening by colonoscopy and polyp removal should significantly reduce colorectal cancer. This has not been the case, as evidenced by recent studies, which revealed that endoscopy failed to prevent up to 50% of all subsequent carcinomas. Flat or depressed adenomas, frequently reported from Japan but rarely elsewhere, might explain the ,missed carcinomas.' Detection of flat adenomas has not been previously reported from Malaysia. Methods: In the present prospective study, 426 consecutive patients underwent colonoscopic examination between March 1997 and January 2000, for a variety of bowel symptoms. The examinations were performed by an experienced endoscopist using a standard colonoscope and methylene blue dye spraying technique. Macroscopically, flat adenomas were defined using the criteria proposed by Sawada. Results: Twenty-nine adenomas were identified in 12 patients, of which 15 were polypoid and 14 were flat, with no depressed lesions. Eight polypoidal lesions and all the flat adenomas contained mild or moderate areas of epithelial dysplasia. Seven severely dysplastic polyps were identified. One Duke's A polypoidal cancer and two advanced carcinomas were also found. All the severely dysplastic lesions and Duke's A carcinomas were found in polyps greater than 10 mm in mean size. The flat adenomas were all less than 5 mm in size. Conclusions: A significant proportion of colonic adenomas in Malaysian patients appear as small flat lesions, which could easily be missed during endoscopy. Increased recognition and treatment of flat adenomas among colonoscopists is warranted. [source] Breast Hamartomas in Adolescent FemalesTHE BREAST JOURNAL, Issue 5 2009Henry L. Chang MD Abstract:, Breast hamartomas are uncommon lesions that have not been extensively characterized in the adolescent population. A search of patient records at our institution over a 17-year period identified seven cases of breast hamartomas in patients less than 18 years of age. We examine and report the clinical, radiographic, and pathologic characteristics of these cases. Breast hamartomas present as painless, palpable masses in the adolescent population. Ultrasonography reveals a well-defined, solid, oval mass, similar to the more common fibroadenoma. Two of the patients underwent core needle biopsy for diagnosis as the only intervention with the remainder undergoing surgical excision. None of the patients had any complications from surgery. There was one recurrence 9 months after initial excision. Histologically, the hamartomas consisted of densely packed, enlarged lobules set within a fibrous stroma. Breast hamartomas are rare in the adolescent population. The clinical and radiographic features are similar to the more common fibroadenoma, but the pathologic findings are diagnostic. Recurrence can occur if excision is incomplete. Increased recognition and accurate diagnosis will improve our understanding of the natural history of these lesions. [source] Residual cognitive impairments in remitted depressed patients,DEPRESSION AND ANXIETY, Issue 6 2008Wendelien Merens M.A. Abstract Depressive disorders are associated with various cognitive impairments. Studies on whether or not these impairments persist into the euthymic phase have shown conflicting results, due to differences in test versions and in study samples. In this paper, we aimed to compare the cognitive performance of remitted depressed patients with that of age- and gender-matched healthy volunteers across a wide range of cognitive domains. In two studies, we found few differences on neutral as well as emotional information processing tests. The findings indicate that remitted depressed patients who use antidepressant medication still show an increased recognition of facial expression of fear compared to healthy controls. Patients also performed worse on a test of recognition of abstract visual information from long-term memory. No other residual cognitive impairments were found. These results indicate that most of the cognitive impairments associated with depression resolve with recovery through medication, even when recovery is incomplete. Considering the finding that remitted depressed patients have higher levels of cognitive reactivity, future studies may investigate the possibility that these cognitive impairments have not resolved but have become latent, and may therefore easily be triggered by small changes in mood state. Depression and Anxiety 0:1,10, 2007. © 2007 Wiley-Liss, Inc. [source] REVIEW: Aortic Atheromas: Current Concepts and Controversies,A Review of the LiteratureECHOCARDIOGRAPHY, Issue 2 2008Thenappan Thenappan M.D. The frequent use of transesophageal echocardiogram (TEE) has led to the increased recognition of aortic atheromas. Retrospective and prospective follow-up studies have reported an association between aortic atheromas and stroke in the high-risk patient population, with complex plaques being more likely to embolize than simple plaques. However, TEE-based studies in the low-risk cohorts have failed to show a similar association. There is growing body of evidence suggesting that aortic atheroma is a marker of generalized atherosclerosis. Although magnetic resonance (MR) imaging and computed tomography (CT) scan are emerging as a powerful noninvasive tool for characterization of aortic atheromas, TEE is the imaging modality of choice. Currently, treatment of aortic atheromas is not well defined, and mixed outcomes have been reported for anticoagulation therapy with warfarin. Statins appear promising based on their plaque stabilization properties. However, there are no randomized control trials to establish the role of both anticoagulation and statins in patients with aortic atheromas, and are warranted in the future. [source] EVOLUTIONARY CONSTRAINT AND ECOLOGICAL CONSEQUENCESEVOLUTION, Issue 7 2010Douglas J. Futuyma One of the most important shifts in evolutionary biology in the past 50 years is an increased recognition of sluggish evolution and failures to adapt, which seem paradoxical in view of abundant genetic variation and many instances of rapid local adaptation. I review hypotheses of evolutionary constraint (or restraint), and suggest that although constraints on individual characters or character complexes may often reside in the structure or paucity of genetic variation, organism-wide stasis, as described by paleontologists, might better be explained by a hypothesis of ephemeral divergence, according to which the spatial or temporal divergence of populations is often short-lived because of interbreeding with nondivergent populations. Among the many consequences of acknowledging evolutionary constraints, community ecology is being transformed as it takes into account phylogenetic niche conservatism and the strong imprint of deep history. [source] Potential and Bottlenecks of Bioreactors in 3D Cell Culture and Tissue ManufacturingADVANCED MATERIALS, Issue 32-33 2009David Wendt Abstract Over the last decade, we have witnessed an increased recognition of the importance of 3D culture models to study various aspects of cell physiology and pathology, as well as to engineer implantable tissues. As compared to well-established 2D cell-culture systems, cell/tissue culture within 3D porous biomaterials has introduced new scientific and technical challenges associated with complex transport phenomena, physical forces, and cell,microenvironment interactions. While bioreactor-based 3D model systems have begun to play a crucial role in addressing fundamental scientific questions, numerous hurdles currently impede the most efficient utilization of these systems. We describe how computational modeling and innovative sensor technologies, in conjunction with well-defined and controlled bioreactor-based 3D culture systems, will be key to gain further insight into cell behavior and the complexity of tissue development. These model systems will lay a solid foundation to further develop, optimize, and effectively streamline the essential bioprocesses to safely and reproducibly produce appropriately scaled tissue grafts for clinical studies. [source] Third time lucky for statutory union recognition in the UK?INDUSTRIAL RELATIONS JOURNAL, Issue 3 2002Stephen Wood A third statutory trade union recognition procedure was introduced in the UK in 2000. This paper explores the scope for increased recognition, employers' willingness to concede recognition, unions' response to the procedure and, finally, the use of it so far. The paper concludes that, while the procedure may be sustainable in the long run, its direct impact on union membership and recognition may be minimal. The indirect effect, through voluntary recognition will be greater. But any reversal in union decline will ultimately be dependent upon successful union recruitment well beyond their conventional territories. [source] THE MEULLENET-OWENS RAZOR SHEAR (MORS) FOR PREDICTING POULTRY MEAT TENDERNESS: ITS APPLICATIONS AND OPTIMIZATIONJOURNAL OF TEXTURE STUDIES, Issue 6 2008Y.S. LEE ABSTRACT The Meullenet-Owens Razor Shear (MORS), recently developed for the assessment of poultry meat tenderness, is a reliable instrumental method. Three different studies were conducted to (1) investigate the adaptation of MORS to an Instron InSpec 2200 tester (InSpec); (2) optimize the number of replications necessary per fillet to obtain a reliable instrumental tenderness mean; and (3) test the efficacy of a blunt version of MORS (BMORS). In study 1, the tenderness of 157 cooked broiler breast fillets was predicted by the MORS performed with both a texture analyzer (MORS standard) and InSpec. The correlation coefficient of 0.95 was reported for the MORS energy obtained from the both tests, indicating that the MORS performed with an InSpec is equivalent to that performed on the more expensive texture analyzer. In study 2, eight shears were taken on each cooked fillet (101 fillets) to determine a recommended number of shears per fillet for the MORS. The composite hypothesis test was conducted considering the average of 8 shears as Y (representative estimated tenderness of a fillet) and the average of 2, 3, 4, 5, 6 or 7 as X (potentials for recommended number of shears). The results showed that the optimal number of replications of the MORS for a reliable estimate of tenderness to be four shears or greater per fillet. A blunt version of MORS (BMORS) was introduced in study 3. A total of 288 broilers (576 fillets) were deboned at eight different postmortem deboning times. Tenderness of cooked fillets was assessed by both the MORS and BMORS on the same individual fillets. Both methods were equivalent in performance for predicting broiler breast meat tenderness, giving a correlation coefficient of 0.99 with all instrumental parameters obtained from both methods. Tenderness intensity perceived by consumers was slightly more highly correlated to BMORS energy (r = ,0.90) than MORS energy (r = ,0.87). The BMORS was recommended to use especially for tough meat because of its better discrimination ability among tough meat. Overall, both the MORS and BMORS were proven to be reliable predictors for broiler breast meat tenderness. PRACTICAL APPLICATIONS The incidence of tough meat has been a major issue the poultry industry faces. Therefore, the need to ensure consumer acceptance and the increased recognition of the importance of tenderness has led to the development of instrumental methods for monitoring meat tenderness. To date, a great deal of efforts has been devoted to the development of such instrumental methods. One promising method is the Meullenet-Owens Razor Shear (MORS). The method has gained in popularity for predicting poultry meat tenderness because of its high reliability as well as simplicity compared with that of other industry standards (Warner-Bratzler shear or Allo-Kramer shear). The MORS is not only as reliable as the industry standards, but also more rapid because of the elimination of the sample cutting steps. The application of the MORS will be of benefit to the poultry industry as it could significantly save labor or time to implement for routine quality control. [source] Testosterone Therapy and Obstructive Sleep Apnea: Is There a Real Connection?THE JOURNAL OF SEXUAL MEDICINE, Issue 5 2007Han M. Hanafy MD ABSTRACT Introduction., With the recent increased recognition and treatment of hypogonadism in men, a caution has been given that testosterone replacement therapy (TRT) may cause or aggravate obstructive sleep apnea syndrome (OSA). Aim., To evaluate the scientific data behind the cautionary statements about TRT and OSA. Main Outcome Measures., Methodology and criteria for such studies and evaluation of documents and results based on methodology, duration, and outcome of treatment. Methods., A review of the literature on the subject of TRT and OSA was performed. The possible mechanisms of action of TRT, on breathing and respiration during sleep were explored. Result., Historically, the first such caution came in 1978. Since then, a few similar incidence reports have been cited. The total number of patients in such reports was very small, very disproportional to the millions of patients treated with TRT. Also, there was a lack of consistent findings connecting TRT to OSA. In addition, different results may occur with physiologic replacement vs. supraphysiologic doses in regard to breathing and OSA. The studies showing the effect of TRT on OSA and breathing were all case studies with small numbers of subjects and showed little effect of TRT on OSA in the majority of case reports. Only one study using supraphysiologic doses was a double-blind, placebo-controlled study, which showed a development of OSA in healthy pooled subjects. The other reports were case studies with limited numbers of subjects, suggesting an inconsistent effect of supraphysiologic TRT on OSA and breathing. Conclusion., Cautionary statements about TRT in OSA appear frequently in the TRT literature and guidelines, despite lack of convincing evidence that TRT causes and/or aggravates OSA. Also, there is a lack of consistency in the findings connecting TRT to OSA. It is evident that the link between TRT and OSA is weak, based on methodological issues in many of the studies, and most studies involved small numbers of men. Further studies in this area are needed. Hanafy HM. Testosterone therapy and obstructive sleep apnea: Is there a real connection? J Sex Med 2007;4;1241,1246. [source] The extent and nature of family alcohol and drug use: findings from the belfast youth development studyCHILD ABUSE REVIEW, Issue 6 2008Andrew Percy Abstract Using data from an ongoing longitudinal study of adolescent drug use, this study examines the proportion of teenagers living with parents who are problem alcohol or drug users. Around two per cent of parents report high levels of problem drinking and one per cent report problem drug use. If a broader definition of hazardous drinking is used, the proportion of teenagers exposed increases to over 15 per cent. When substance use is examined at a family level (taking account of alcohol and drug use amongst dependent children in addition to that of parents), the proportion of families experiencing some form of substance use is considerable. These findings add further support to the call for increased recognition of the needs of dependent children within adult treatment services when working with parents. Likewise, the reduction of harm to children as a result of parental substance use should be an increasingly important priority for family support services. This is likely to be achieved through the closer integration of addiction and family services. Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||