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Indications
Kinds of Indications Terms modified by Indications Selected AbstractsSECOND LOOK COLONOSCOPY: INDICATION AND REQUIREMENTSDIGESTIVE ENDOSCOPY, Issue 2009Jean-Francois Rey Background:, There are circumstances when a colonoscopy should be repeated after a short interval following the first endoscopic procedure which has not completely fulfilled its objective. Review of the literature:, A second look colonoscopy is proposed when there remains a doubt about missed neoplastic lesions, either because the intestinal preparation was poor or because the video-endoscope did not achieved a complete course in the colon. The second look colonoscopy is also proposed at a short interval when it is suspected that the endoscopic removal of a single or of multiple neoplastic lesions was incomplete and that a complement of treatment is required. When the initial endoscopic procedure has completely fulfilled its objective, a second look colonoscopy can be proposed at longer intervals in surveillance programs. The intervals in surveillance after polypectomy are now adapted to the initial findings according to established guidelines. This also applies to the surveillance of incident focal cancer in patients suffering from a chronic inflammatory bowel disease. Conclusion:, Finally, in most developed countries, a priority is attributed to screening of colorectal cancer and focus is given on quality assurance of colonoscopy which is considered as the gold standard procedure in the secondary prevention of colorectal cancer. [source] ROCK SURFACE HARDNESS AS AN INDICATION OF EXPOSURE AGE: AN ARCHAEOLOGICAL APPLICATION OF THE SCHMIDT HAMMER,ARCHAEOMETRY, Issue 1 2000M. W. BETTS A Schmidt Hammer was employed in evaluating the surface hardness of rocks which line ancient anthropogenic pit features, known as Pukaskwa pits, on the north shore of Lake Superior, Canada. This technique offers a possible new method of producing relative ana absolute dates for such exposed stone features Analysis of the data has provided a relative chronology for the pit features, representing two distinct construction phases. The range of absolute dates generated from the data indicates that the pits were likely constructed by Blackduck peoples c. 900 to 400 years BP. [source] SURGICAL INDICATIONS AND PROCEDURES FOR BLEEDING PEPTIC ULCERDIGESTIVE ENDOSCOPY, Issue 2010Nobutsugu Abe Recent important insights into the surgical treatment of bleeding peptic ulcer are reviewed in this article. Although the widespread use of endoscopic treatment and interventional radiology has reduced the number of surgical cases, surgery still plays a pivotal role in managing bleeding peptic ulcer. Failure to stop the bleeding by endoscopy and/or interventional radiology is the most important indication for emergency surgery. An early elective/planned surgery after the initial endoscopic control to prevent life-threatening rebleeding seems justified in patients who have risk factors for rebleeding, although its true efficacy still remains controversial. The surgical procedures in emergency situations should be limited to safe hemostasis. The addition of acid-reduction surgery may be unnecessary as a result of the increasing utilization of proton pump inhibitors. Angiographic embolization may be a less invasive alternative to surgery, and may further enhance endoscopic hemostasis. [source] VARIABILITY IN HEDONICS: INDICATIONS OF WORLD-WIDE SENSORY AND COGNITIVE PREFERENCE SEGMENTATIONJOURNAL OF SENSORY STUDIES, Issue 3 2000HOWARD R. MOSKOWITZ ABSTRACT This paper approaches inter-individual differences in the hedonics of food products as an indication of the existence of different groups of people with different likes and dislikes. Rather than considering the differences as an unpleasant fact of nature, to be ignored, the paper shows how these differences point to segments of consumers in the population. These segments enable the product developer to create different types of food products, in order to satisfy the different tastes. The paper, presenting an algorithm for segmentation of individuals into different groups, results from three studies with foods, and the extension of the particular segmentation algorithm into concepts (with three additional studies). The paper presents both new data and results from previously published research. These data are presented in a case history format. [source] GENERATORS: ALL ECG INDICATIONS 1999PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2000Article first published online: 9 OCT 200 No abstract is available for this article. [source] Indication of Endoscopic Papillectomy for Tumors of the Papilla of Vater and Its ProblemsDIGESTIVE ENDOSCOPY, Issue 2003HIROYUKI MAGUCHI Discussions have just started in Japan as to the indication, technique and complication of endoscopic papillectomy for tumors of the papilla of Vater. We indicate endoscopic papillectomy for tumors satisfying the following: 1exposed tumor-type adenoma, or carcinoma in adenoma; 2without invasion of duodenal muscularis; and 3no infiltration into the pancreas or the bile duct. Endoscopic papillectomy was performed on 12 patients with tumors of the papilla of Vater that satisfied the above criteria. En bloc snare excision was achieved in 11 out of 12 cases without endoscopic sphincterotomy (EST) or epinephrine injection. Pancreatic stenting was done in 8 cases for prevention of pancreatitis, and bile duct stenting in nine cases for prevention of cholangitis. Postoperative early complications were observed in 5 cases; pancreatitis in 2; pancreatitis and bleeding in 1; bleeding in 1; and bleeding and perforation in 1. Neither recurrence nor metastasis of tumor has been detected during the average postoperative period of 620 days. The treatment can be acknowledged as less invasive therapy. However, management of complications is important, for which further study needs to be accumulated. [source] Indication of antagonistic interaction between climate change and erosion on plant species richness and soil properties in semiarid Mediterranean ecosystemsGLOBAL CHANGE BIOLOGY, Issue 2 2009PATRICIO GARCÍA-FAYOS Abstract We analyzed the consequences of climate change and the increase in soil erosion, as well as their interaction on plant and soil properties in semiarid Mediterranean shrublands in Eastern Spain. Current models on drivers of biodiversity change predict an additive or synergistic interaction between drivers that will increase the negative effects of each one. We used a climatic gradient that reproduces the predicted climate changes in temperature and precipitation for the next 40 years of the wettest and coldest end of the gradient; we also compared flat areas with 20° steep hillslopes. We found that plant species richness and plant cover are negatively affected by climate change and soil erosion, which in turn negatively affects soil resistance to erosion, nutrient content and water holding capacity. We also found that plant species diversity correlates weakly with plant cover but strongly with soil properties related to fertility, water holding capacity and resistance to erosion. Conversely, these soil properties correlate weaker with plant species cover. The joint effect of climate change and soil erosion on plant species richness and soil characteristics is antagonistic. That is, the absolute magnitude of change is smaller than the sum of both effects. However, there is no interaction between climate change and soil erosion on plant cover and their effects fit the additive model. The differences in the interaction model between plant cover and species richness supports the view that several soil properties are more linked to the effect that particular plant species have on soil processes than to the quantity and quality of the plant cover and biomass they support. Our findings suggest that plant species richness is a better indicator than plant cover of ecosystems services related with soil development and protection to erosion in semiarid Mediterranean climates. [source] A multi-intervention approach on drug therapy can lead to a more appropriate drug use in the elderly.JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2009LIMM-Landskrona Integrated Medicines Management Abstract Rationale, aims and objectives, To evaluate if an integrated medicines management can lead to a more appropriate drug use in elderly inpatients. Method, The study was an intervention study at a department of internal medicine in southern Sweden. During the intervention period pharmacists took part in the daily work at the wards. Systematic interventions aiming to identify, solve and prevent drug-related problems (DRPs) were performed during the patient's hospital stay by multidisciplinary teams consisting of physicians, nurses and pharmacists. DRPs identified by the pharmacist were put forward to the care team and discussed. Medication Appropriateness Index (MAI) was used to evaluate the appropriateness in the patients' drug treatment at admission, discharge and 2 weeks after discharge. In total 43 patients were included, 28 patients in the intervention group and 25 patients in the group which was used as control. Results, For the intervention group there was a significant decrease in the number of inappropriate drugs compared with the control group (P = 0.049). Indication, duration and expenses were the MAI-dimensions with most inappropriate ratings, and the drugs with most inappropriate ratings were anxiolytics, hypnotics and sedatives. Conclusion, This kind of systematic approach on drug therapy can result in a more appropriate drug use in the elderly. [source] Indication and Techniques of Transcatheter Closure of Patent Foramen OvaleJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 6 2003RAINER SCHRÄDER M.D. A potential causal relationship of a patent foramen ovale (PFO) and a stroke was first suggested by Cohnheim in 1877.1 Today, this correlation is generally accepted. However, there is still no "gold standard" for the treatment of patients with presumed paradoxical embolism. This article reviews the epidemiology of and the diagnostic methods for PFO, the clinical relationship between PFO and cerebral ischemia, as well as indications and techniques for transcatheter closure of PFO. In the author's opinion, transcatheter PFO closure represents an elegant management for selected patients at risk. (J Interven Cardiol 2003;16:543,551) [source] Safety, Efficacy, and Cost Advantages of Combined Coronary Angiography and AngioplastyJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2003CLAUDE LE FEUVRE M.D., F.E.S.C. Aim: The safety and efficacy of ad hoc PTCA has been previously reported and this approach is performed in many angioplasty centers as a routine procedure. The aim of this study is to examine whether this approach reduces the length, and cost of hospital stay. Methods and results: To determine the hospital costs we studied 2,440 PTCAs over 11 years in our institution (1990,2000). Urgent PTCA for acute coronary syndromes refractory to medical treatment were excluded. In 1809 patients (74%) angioplasty was performed immediately after coronary angiography, while separate procedures were performed in 631 patients. Indication for PTCA was unstable angina in 1342 patients (55%). In the ad hoc PTCA group, 92% of the culprit lesions were successfully treated; complications included myocardial infarction (2%), urgent bypass surgery (0.6%) and death (0.9%). The rate of combined procedure progressively increased from 54% in 1990 to 88% in 2000, with a significant decrease in the rate of complications. After adjusting for clinical and angiographic differences between combined and separate procedures, angiographic success and complication rates were not statistically different in the two groups. Mean length of hospital stay decreased all along the years, and was 45% less in the ad hoc PTCA group (11.4 ± 6.9vs18.2 ± 7.7in 1990,5.4 ± 4.3vs10.8 ± 5.7in 2000,P < 0.0001). The cost was 40% lower in the ad hoc PTCA group. For patients with stable angina, the savings were 49%, and for those with unstable angina, they were 29%. Conclusion: In the era of coronary stenting, ad hoc PTCA can be performed in most of the patients as safely and successfully as a separate procedure. It reduces the length, and the cost of hospital stay in patients with stable or unstable angina. (J Interven Cardiol 2003;16:195,199) [source] Bullous pemphigoid detection by micro-Raman spectroscopy and cluster analysis: structure alterations of proteinsJOURNAL OF RAMAN SPECTROSCOPY, Issue 11 2005Erez Azrad Abstract In this study, micro-Raman spectroscopy was used, for the first time, to detect spectral changes between healthy and diseased skin tissues with bullous pemphigoid (BP). The spectral changes provide information about the biochemical alterations between normal skin and blistered and nonblistered regions in samples diagnosed histopathologically as BP. Raman spectra, characterized by many peaks, revealed the molecular composition of the different skin layers, stratum corneum, epidermis and dermis of normal skin. Comparison of spectra monitored at the dermoepidermal junction (DEJ) of healthy skin with those of blisters caused by BP showed evidence for large variations in the amide I and III regions. The alterations of the protein content, amide I and III, are a result of the appearance of immunoglobulin G (IgG) and fibrin, characteristics of BP. Indication for the disease at early stages was obtained from changes in protein content, evidenced in the measured spectra assisted by cluster analysis. The method employed here can contribute to the nearly real-time diagnosis and to a better understanding of the physical and biomolecular processes effected by BP, and might have implications on other skin diseases. Copyright © 2005 John Wiley & Sons, Ltd. [source] Conversion to sirolimus-based immunosuppression in maintenance liver transplantation patientsLIVER TRANSPLANTATION, Issue 5 2007Isabelle Morard Sirolimus (SRL) has been proposed to replace calcineurin inhibitors (CNI) in case of CNI-induced toxicity. The aim of this study was to evaluate the efficacy and safety of conversion from CNI to SRL in maintenance liver transplantation (LT) patients. Between 2002 and 2006, conversion was performed in 48 patients (17 female, 31 male; mean age 57 ± 10 yr) after a median delay of 19.4 months (range 0.2,173 months) after LT. Indication for conversion was renal impairment (RI) (78%), CNI neurotoxicity (13%), or post-LT cancer (9%). Median follow-up was 22.6 ± 11 months. Median SRL dosage and trough levels were 2.4 ± 1.3 mg and 8.1 ± 2.7 ,g/L. Immunosuppression consisted of SRL alone (33%), or SRL + mycophenolate mofetil (MMF) (39%), SRL + prednisone (15%), SRL + CNI (4%), or SRL + MMF + prednisone (8%). Mean glomerular filtration rate (GFR) improved from 33 to 48 mL/minute in patients with severe RI (P = 0.022) and from 56 to 74 mL/minute in patients with moderate RI (P = 0.0001). After conversion, main complications were albuminuria (36%), hyperlipidemia (49%), dermatitis (14%), edema (14%), oral ulcers (12%), joint pain (4%), infection (2%), and pneumonia (2%). Acute rejection (AR) occurred in 17% of the patients. SRL was withdrawn in 17% of the patients. In conclusion, conversion from CNI to SRL is safe and is associated with significant renal function improvement. Liver Transpl 13:658,664, 2007. © 2007 AASLD. [source] Indication of Local Phase Separation in Polyimide/Silica Hybrid Polymers,MACROMOLECULAR CHEMISTRY AND PHYSICS, Issue 16 2010Antonino Bartolotta Abstract PI/SiO2 hybrid polymers involving the in situ generation of SiO2 particles through the sol/gel route have emerged as promising materials in many fields of modern technology thanks to their unique structural characteristics. In this paper their structural and dynamic properties were investigated by FT-IR and DMTA as a function of SiO2 content. All data consistently highlight a loosening of polymeric structure due to the presence of SiO2 nanoparticles and suggest a silica-induced structural change most probably due to a sub-micrometer scale SiO2 phase separation. Our results demonstrate how the analysis of sub-glass ,-relaxation dynamics can be exploited to investigate sub-micro phase segregation in such materials. [source] Long-Term Effects of Upgrading to Biventricular Pacing: Differences with Cardiac Resynchronization Therapy as Primary IndicationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 7 2010GAETANO PAPARELLA M.D. Background: Few studies have assessed the long-term effects of cardiac resynchronization therapy (CRT) in patients with advanced heart failure (HF) and previously right ventricular apical pacing (RVAP). Aims: To assess the clinical and hemodynamic impact of upgrading to biventricular pacing in patients with severe HF and permanent RVAP in comparison with patients who had CRT implantation as initial therapy. Methods and Results: Thirty-nine patients with RVAP, advanced HF (New York Heart Association [NYHA] III,IV), and severe depression of left ventricular ejection fraction (LVEF) were upgraded to biventricular pacing (group A). Mean duration of RVAP before upgrading was 41.8 ± 13.3 months. Clinical and echocardiographic results were compared to those obtained in a group of 43 patients with left bundle branch block and similar clinical characteristics undergoing "primary" CRT (group B). Mean follow-up was 35 ± 10 months in patients of group A and 38 ± 12 months in group B. NYHA class significantly improved in groups A and B. LVEF increased from 0.23 ± 0.07 to 0.36 ± 0.09 (P < 0.001) and from 0.26 ± 0.02 to 0.34 ± 0.10 (P < 0.001), respectively. Hospitalizations were reduced by 81% and 77% (P < 0.001). Similar improvements in echocardiographic signs of ventricular desynchronization were also observed. Conclusion: Patients upgraded to CRT exhibit long-term clinical and hemodynamic benefits that are similar to those observed in patients treated with CRT as initial strategy. (PACE 2010; 841,849) [source] Criteria for Pacemaker Explant in Patients Without a Precise Indication for Pacemaker ImplantationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2002MARTINO MARTINELLI MARTINELLI, M., et al.: Criteria for Pacemaker Explant in Patients Without a Precise Indication for Pacemaker Implantation. Unnecessary pacemaker implantation may cause significant social and psychological consequences, the inconvenience of periodic office visits, and the expense of pulse generator replacement. Establishing adequate criteria for explanting pacemakers is crucial and has not yet been described. This study presents the results of a study protocol for explanting the pacemaker in patients without a clear indication for pacemaker implantation. Seventy pacemaker users without a clear reason for the implantation were included in the study conducted from August 1986 to November 1998 and were prospectively followed. The investigation consisted of clinical and neurological evaluations, echocardiogram, exercise testing, and tilt table testing. When these tests were negative, the pulse generator energy and stimulation rates were reprogrammed to the lowest values. Periodic Holter monitoring was conducted during follow-up. When asymptomatic for 1 year, patients underwent an electrophysiological evaluation of sinus and atrioventricular junction function and ventricular vulnerability. When the electrophysiological study was negative, pacemaker explantation was performed. Of the 70 patients, 35 had their pacemaker explanted; 3 were excluded due to a positive tilt table test and electrophysiological study, and 3 are waiting for pacemaker explantation. Mean follow-up after pacemaker explantation was 30.3 months, and all patients remained asymptomatic, except for one patient who died of a noncardiac cause. Critical analysis of pacemaker users without a well-established indication is justified because it may allow pacemaker explant in a significant proportion of these patients, and it may bring considerable social, economic, and psychological benefits. [source] Use of albumin in three French university hospitals: is prescription monitoring still useful in 2004?,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 1 2007Vincent Pradel MD Abstract Purpose Use of albumin (indications and quantities involved) has not been assessed in France since major changes occurred after the publication of Cochrane group meta-analysis. The objectives of this study were to measure the repartition of albumin indications in three French university hospitals in 2004 and to assess the feasibility and usefulness to implement a prescription-monitoring program. Methods Exhaustive record of albumin prescription during 2 months in three French university hospitals of Marseille. Inclusion of all patients with a first prescription of albumin between 15 March 2004 and 15 May 2004. Indication, formulation and quantity prescribed were recorded for each prescription. Results One hundred and eighty-seven patients received a total of 426 prescriptions for a total quantity of 21,094 g of albumin during the study. The first indications were hypoalbuminemia (33% of total quantity), plasmapheresis (30.2%) and ascites or hepatorenal syndrome (13.7%). Fifty per cent of total quantity was used by 14 patients (7.5% of included patients). Conclusions Most of albumin consumption in our study is concentrated on recognized indications or indications without alternative to albumin. The different levels of analysis (number of patient treated, number of prescription and quantities used) must be taken into account when analyzing medications such as albumin. Only a marginal proportion of consumption is expected to be saved with close monitoring of indications. Copyright © 2006 John Wiley & Sons, Ltd. [source] Basmati Rice: Geographical Indication or Mis-IndicationTHE JOURNAL OF WORLD INTELLECTUAL PROPERTY, Issue 2 2006Harsh V. Chandola Indian farmers may not understand the Lockean or the Hegelian justification for intellectual property. Neither do they understand the politics (realpolitik) of the negotiations of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). Many of them had no idea that in September 2003 their fate might have been decided in the Cancun Ministerial meeting of World Trade Organization (WTO) member countries. But they do understand simple economics, i.e. if the American company which has registered a patent for basmati rice continues to sell rice as American-style basmati rice, it may hurt their exports. If the Indian Government had a key to the past, they would have definitely renegotiated-TRIPS to protect $350 million export market of basmati rice. Even if we opprobrium TRIPS and characterize it as an instrument of exploitation used by developed countries to protect their own interest, the fact of the matter is, there is no escape from it. Withdrawing from TRIPS entails too many implications for the Indian economy, and it would be cynical to suggest such an idea. Developing and least developed countries have fallen to the economic and political pressure of the Developed countries, and the former group of countries will never be able to convince the latter to renegotiate TRIPS to bring a balance to it, even if their call is eloquent, justified and reflects reality. It would be like knocking on the lid of a coffin: knock, as much as you like, you will not wake him. Post-Cancun (WTO Ministerial Meeting), it is vital for the Indian Government to formulate strategies to protect its interest in TRIPS. The strategy should focus on the options available within the TRIPS framework. We might have lost advantage in the field of patents to western pharmaceutical companies, but if a proper strategy is formulated we will be able to protect our basmati exports. [source] Distribution and Forming Model of Fluvial Terrace in the Huangshui Catchment and its Tectonic IndicationACTA GEOLOGICA SINICA (ENGLISH EDITION), Issue 2 2010Xianyan WANG Abstract: The Huang Shui River, a main tributary of the Yellow River, crosses a series of tectonically subsided and uplifted areas that show different patterns of terrace formation. The distribution of fluvial terrace of the Huang Shui River is studied through topographic and sedimentologic terrace mapping. Three terraces in the Haiyan Basin, four terraces in the Huangyuan Basin, 19 terraces in the Xi'ning Basin (the four high terraces may belong to another river), nine terraces in the Ping'an Basin, five terraces in the Ledu Basin and 12 terraces in the Minhe Basin are recognized. Sedimentology research shows that the geomorphologic and sedimentological pattern of the Huang Shui River, which is located at the margin of Tibet, are different from that of the rivers at other regions. The formation process of the terrace is more complicated at the Huang Shui catchment: both accumulation terrace and erosion terrace were formed in each basin and accumulation terraces were developed in some basins when erosion terraces were formed in other basins, indicating fluvial aggradation may occur in some basins simultaneously with river incision in other basins. A conceptual model of the formation process of these two kinds of fluvial terraces at Huang Shui catchment is brought forward in this paper. First, the equilibrium state of the river is broken because of climatic change and/or tectonic movement, and the river incises in all basins in the whole catchment until reaching a new equilibrium state. Then, the downstream basin subsides quickly and the equilibrium state is broken again, and the river incises at upstream basins while the river accumulates at the subsidence basin quickly until approaching a new equilibrium state again. Finally, the river incises in the whole catchment because of climatic change and/or tectonic movement and the accumulation terrace is formed at the subsidence basin while the erosion terrace is formed at other basins. The existence of the accumulation terrace implied the tectonic subsidence in the sub-basins in Huang Shui catchment. These tectonic subsidence movements gradually developed from the downstream Minhe Basin to the upstream Huangyuan Basin. Dating the terrace sequence has potential to uncover the relationship between the subsidence in the catchment and the regional tectonic at the northeastern Tibetan Plateau. [source] Migration of Depocenters and Accumulation Centers and its Indication of Subsidence Centers in the Mesozoic Ordos BasinACTA GEOLOGICA SINICA (ENGLISH EDITION), Issue 2 2009Junfeng ZHAO Abstract: Based on the integrated study of structure attributions and characteristics of the original basin in combination with lithology and lithofacies, sedimentary provenance analysis and thickness distribution of the Mesozoic Ordos Basin, it is demonstrated that the depocenters migrated counterclockwise from southeast to the north and then to the southwest from the Middle-Late Triassic to the Early Cretaceous. There were no unified and larger-scale accumulation centers except several small isolated accumulation centers before the Early Cretaceous. The reasons why belts of relatively thick strata were well developed in the western basin in several stages are that this area is near the west boundary of the original Ordos Basin, there was abundant sediment supply and the hydrodynamic effect was strong. Therefore, they stand for local accumulation centers. Until the Early Cretaceous, depocenters, accumulation centers and subsidence centers were superposed as an entity in the southwest part of the Ordos Basin. Up to the end of the Middle Jurassic, there still appeared a paleogeographic and paleostructural higher-in-west and lower-in-east framework in the residual basin to the west of the Yellow River. The depocenters of the Ordos Basin from the Middle,Late Triassic to the Middle Jurassic were superposed consistently. The relatively high thermal maturation of Mesozoic and Paleozoic strata in the depocenters and their neighborhood suggest active deep effects in these areas. Generally, superposition of depocenters in several periods and their consistency with high thermal evolution areas reveal the control of subsidence processes. Therefore, depocenters may represent the positions of the subsidence centers. The subsidence centers (or depocenters) are located in the south of the large-scale cratonic Ordos Basin. This is associated with flexural subsidence of the foreland, resulting from the strong convergence and orogenic activity contemporaneous with the Qinling orogeny. [source] ,-Adrenoceptor agonists for the treatment of vasovagal syncope: a meta-analysis of worldwide published dataACTA PAEDIATRICA, Issue 7 2009Ying Liao Abstract Aim:, The present study was aimed at evaluating present randomized controlled trials (RCTs) regarding the effect of ,-adrenoceptor agonists on vasovagal syncope (VVS). Methods:, According to inclusion and exclusion criteria, articles were selected from medical electronic databases. RCTs were then assessed based on the Juni assessment, and meta-analysis was completed using the Review Manager 4.2 software. Indication to further evaluate effects was the recurrence of syncope during follow-up treatment or a response in the head-up tilt test (HUT) after treatment. The results were stated as odd ratio (OR), with a 95% confidence interval (CI) and a p < 0.05 significant level. Results:, In total, six RCTs were selected. Funnel plot analysis showed possible publication bias. Meta-analysis of the six RCTs, including all 165 patients in the treatment group and 164 patients in the control group, indicated that ,-adrenoceptor agonists were more effective than placebos in treating VVS (OR = 0.21, 95% CI: 0.06,0.77, p = 0.02). The further, weighted independent t- test disclosed that the weighted mean percentage of responders for midodrine (76.3%± 7.7%) was significantly higher than that for etilefrine (65.5%± 15.4%) (t = 5.863, p < 0.001). Conclusion:, The currently published RCTs support that ,-adrenoceptor agonists might be effective for VVS. Midodrine can be regarded as a better choice compared with etilefrine. [source] China as a Net Creditor: An Indication of Strength or Weaknesses?CHINA AND WORLD ECONOMY, Issue 6 2007Xin Wang E44; F21; F31; F41 Abstract China's international investment position is characterized by large net foreign assets, a dominance of low-return foreign exchange reserves and costly foreign direct investment in foreign assets and foreign liabilities. In addition, China's foreign investment positions are facing potentially large exchange risks. These features reflect entrenched institutional and structural problems in China, including underdeveloped capital markets, biased resource allocation and a defective social security system. China's net creditor status might actually be an indication of weakness rather than strength. To improve its international investment position, China must speed up economic reforms and allow the market to play a fundamental role in resource allocation. [source] Indication for a role of regulatory T cells for the advent of influenza A (H1N1)-related pneumoniaCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2010M. Raftogiannis Summary Regulatory T cells (Tregs) have an anti-inflammatory role. A former study in a limited number of patients found that absolute counts of Tregs increase when infection by the new influenza H1N1 virus is complicated with pneumonia. These results generate the question if H1N1-related pneumonia is associated with a state of hypo-inflammation. A total of 135 patients were enrolled with blood sampling within less than 24 h from diagnosis; 23 with flu-like syndrome; 69 with uncomplicated H1N1-infection; seven with bacterial pneumonia; and 36 with H1N1-related pneumonia. Tregs and CD14/HLA-DR co-expression were estimated by flow cytometry; concentrations of tumour necrosis factor-alpha (TNF-,), of interleukin (IL)-6 and of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) by an enzyme immunoassay; those of procalcitonin (PCT) by immuno-time-resolved amplified cryptate technology assay. Expression of human leucocyte antigen D-related (HLA-DR) on monocytes was similar between groups; absolute Treg counts were greater among patients with H1N1-related pneumonia than flu-like syndrome or H1N1-uncomplicated infection. Serum TNF-, of patients with bacterial pneumonia was greater than those of other groups, but IL-10 was similar between groups. Serum PCT was greater among patients with H1N1-related pneumonia and sTREM-1 among those with H1N1-related pneumonia. Regression analysis revealed that the most important factors related with the advent of pneumonia were the existence of underlying illnesses (P = 0·006) and of Tregs equal to or above 16 mm3 (P = 0·013). It is concluded that the advent of H1N1-related pneumonia is related to an early increase of the absolute Treg counts. This increase is probably not part of a hypo-inflammatory state of the host. [source] Purine Metabolism in Heart Failure: Oxidant Biology and Therapeutic IndicationsCONGESTIVE HEART FAILURE, Issue 5 2008John Anthony Bauer PhD No abstract is available for this article. [source] Review of Fractional Photothermolysis: Treatment Indications and EfficacyDERMATOLOGIC SURGERY, Issue 10 2009EMILY P. TIERNEY MD BACKGROUND Fractional photothermolysis (FP) is one of the most significant milestones in laser technology and resurfacing. METHODS Review of the Medline English literature and recent international conferences regarding FP technology, applications, and indications. RESULTS Successful conditions treated with nonablative FP reported in the literature include acne scarring; dyschromia and fine wrinkling of photoaging on the face, chest, neck, and hands; melasma; poikiloderma of Civatte; nevus of Ota; scars; minocycline hyperpigmentation; telangiectatic matting; residual hemangioma; granuloma annulare; colloid milium; and disseminated superficial actinic porokeratosis. An advance in 2007 was the introduction of ablative FP (AFP), which results in significantly greater improvement in skin laxity and textural abnormalities. Most recently, AFP has demonstrated significantly greater improvement than nonablative FP in reducing acne scarring and skin redundancy and laxity associated with photoaging. CONCLUSIONS Through the induction of microthermal zones of injury, FP technology stimulates a robust and rapid wound healing response resulting in improvement in a diversity of aesthetic, inflammatory, and preneoplastic skin disorders. Further investigation into the technology and diverse array of cutaneous conditions that can benefit from FP is highly needed. [source] Nail Biopsy: Assessment of Indications and OutcomeDERMATOLOGIC SURGERY, Issue 2 2005Chander Grover MD, MNAMS Background For years, nail biopsy has been shunned as a difficult and scarring procedure, which is seldom required in day-to-day practice. Only a few studies with a limited number of patients have been carried out to assess its utility in dermatology. Methods We studied 270 patients with nail disorders (both infectious and noninfectious). In 205 cases, the clinical diagnosis could be confirmed with the help of routine diagnostic aids, in the form of potassium hydroxide preparation, fungal culture, and biopsy of associated skin lesions. In the remaining 65 cases, various types of nail biopsies were carried out after ruling out contraindications to nail surgery. Results Overall, the histopathologic changes were found to be diagnostic in 63% of cases. Findings were more characteristic in infectious disorders of the nail unit. The diagnostic yield varied with the type of biopsy procedure. Side effects in the form of scarring and nail dystrophy were seen in 29.2% of the patients. Discussion Nail biopsy is useful, especially in cases with isolated nail involvement, an absence of skin lesions, and disorders such as twenty-nail dystrophy. It should be advocated in cases in which the routine diagnostic procedures fail to yield results. Proper selection of cases, choice of biopsy technique, and attention to the surgical procedure help in minimizing the side effects associated with the procedure. Conclusion Nail biopsy was found to be a simple, safe, and useful procedure, especially in cases in which the clinical diagnosis is otherwise obscure. CHANDER GROVER, MD, DNB, MNAMS, SONI NANDA, MD, B. S. N. REDDY, MD, MNAMS, AND KRISHNAMOORTHY UMA CHATURVEDI, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPPORTERS. [source] The use of systemic antibiotics in the treatment of chronic woundsDERMATOLOGIC THERAPY, Issue 6 2006Robert Hernandez ABSTRACT:, The role of microorganisms in the etiology and persistence of chronic wounds remains poorly understood. The chronic wound bed houses a complex microenvironment that typically includes more than one bacterial species. Difficulty lies in determining when the presence of bacteria impedes wound healing, thereby warranting intervention. Indications for antibiotic therapy and optimal treatment regimens are ill defined. The goal of this article is to describe the appropriate role of systemic antibiotics in the management of chronic wounds. A common sense approach will be offered based on six clinically pertinent questions: ,,Is infection present? ,,Are systemic antibiotics necessary? ,,Should treatment be enteral or parenteral? ,,What antibiotic or combination of antibiotics should be used? ,,What should be the duration of therapy? ,,What special circumstances are present (i.e., concomitant illnesses, potential drug,drug interactions) that can impact therapy? [source] Are Geographical Indications a Valid Property Right?DEVELOPMENT POLICY REVIEW, Issue 5 2009Challenges, Global Trends This article explores what is at stake in the international conflict on geographical indications (GIs), particularly for developing countries. It first examines how the WTO panel has obliged the European Union to open its registration system to third countries and how the ongoing negotiations on GIs seem to be reaching stalemate. Initiatives showing how GIs are a key political and trade issue are identified in Turkey, India, China, Colombia and Ethiopia. Trade negotiation agendas have to handle this new balance of power, in which the reputation accompanying a good may become common. [source] Plenary Lecture: Broadening of the Indications for Endoscopic Surgery: Upper Gastrointestinal TractDIGESTIVE ENDOSCOPY, Issue 2000Shuji Inatsuchi First page of article [source] Discussant's Comment: Endoscopic Ultrasonography in Determining the Indications for Endoscopic Resection in Early Colorectal CancerDIGESTIVE ENDOSCOPY, Issue 2000Seiji Shimizu No abstract is available for this article. [source] The male postabdomen of Stolotermes inopinus: a termite with unusually well-developed external genitalia (Dictyoptera: Isoptera: Stolotermitinae)ACTA ZOOLOGICA, Issue 2 2000Klaus-Dieter Klass Abstract Klass, K.-D., Thorne, B. L. and Lenz, M. 2000. The male postabdomen of Stolotermes inopinus: a termite with unusually well-developed external genitalia (Dictyoptera: Isoptera: Stolotermitinae). ,Acta Zoologica (Stockholm) 81: 121,130 Stolotermes inopinus has large external male genitalia (phallic lobe), which contrast with the small genital papillae or lack of external genitalia of other Isoptera. As in the genital papilla of Mastotermesdarwiniensis, a ventral sclerite pair is present, the gonopore is located ventroterminally on the phallic lobe, and the genital area is entirely symmetrical , suggesting that this may be the groundplan condition of Isoptera. The relations of the phallic lobe to surrounding components like the subgenital plate, paraprocts, and certain muscles and nerves indicate that the lobe of S. inopinus is homologous with the phallomeres of other Dictyoptera. The bilateral symmetry and simple structure, however, are in strong contrast to the asymmetry and high complexity found in male genitalia of Blattaria and Mantodea. The postabdominal nervous system of S. inopinus resembles that of the cockroach Periplaneta americana. Indications are given that the Stolotermitinae are related to the Kalotermitidae, Rhinotermitidae, and Termitidae rather than to the Termopsinae. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||