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Low Compliance (low + compliance)

Distribution by Scientific Domains
Medical Sciences90%

Selected Abstracts

Low compliance with colonoscopic screening in first-degree relatives of patients with large adenomas

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2006
V. COTTET
Summary Background Little is known about compliance with colonoscopy as a screening method in first-degree relatives of patients with large adenomas. Aims To evaluate the compliance with screening colonoscopy among this population, and its determinants. Methods Data were obtained from the family part of the GEADE study, a study on genetic factors of colorectal adenomas. Index cases were 306 patients with adenomas , 10 mm. All living first-degree relatives aged 40,75 who could be contacted by the index case were asked to undergo a colonoscopy, unless they had had one in the previous 5 years. Results Among 674 eligible relatives, 56 had had a colonoscopy within the preceding 5 years and 114 underwent a screening colonoscopy resulting in a compliance with screening colonoscopy of 18%. This was not related to most characteristics of index cases. Compliance was significantly lower when the index case lived in the Greater Paris area than when he/she lived in other areas (12% vs. 21%). It was higher in siblings (18%) and offspring (23%) than in parents (9%) and in relatives under 55 years old (22%) than in relatives aged 55 and over (15%). Conclusions Compliance with colonoscopy was low in first-degree relatives of patients with large adenomas. The reasons for this should be determined and appropriate strategies developed to increase compliance. [source]

Circulation in normal and inflamed dental pulp

ENDODONTIC TOPICS, Issue 1 2007
ELLEN BERGGREEN
In the pulp, arteries branch into a capillary network before they leave the pulp as venules through the apical foramina. The tissue has low compliance, as it is enclosed in dentin, and has a relatively high blood flow and blood volume. The interstitial fluid pressure (IFP) and colloid osmotic pressure are relatively high whereas the net driving blood pressure is low. The high pulsatile IFP is probably the major force for propelling lymph in the dental pulp. Vasodilation in neighboring tissue as well as arteriovenous (AV) shunts in the pulp itself can contribute to a fall in total and coronal pulpal blood flow, respectively. The pulp blood flow is under nervous, humoral, and local control. Inflammatory vascular responses, vasodilation, and increased vessel permeability induce an increase in IFP that can be followed by a temporarily impaired blood flow response. Lipopolysaccharides (LPS) from bacteria may cause endothelial activation in the pulp, leading to vasoconstriction and reduced vascular perfusion. Lymphatic vessels are identified with specific lymphatic markers in the pulp but so far, little is known about their function. Because of the special circulatory conditions in the pulp, there are several clinical implications that need to be considered in dental treatment. Received 13 February 2009; accepted 28 August 2009. [source]

Inflammatory nerve responses in the dental pulp

ENDODONTIC TOPICS, Issue 1 2007
INGE FRISTAD
Tooth pulp has a dense innervation and a rich vascular supply to maintain homeostasis and to preserve the integrity of the tissue. Function, trauma, and antigenic challenges make teeth and supporting tissues susceptible to tissue injury and inflammation, partially due to the lack of collateral blood and nerve supply and to their low compliance. This review focuses on dental nerve functions and adaptive changes in the pulpal nerve supply following inflammation and peripheral injury. Overviews of dental innervation and its development and of the peptidergic innervation of oral tissues are presented, followed by a discussion of peripheral and central changes after local insults to teeth and peripheral nerve injuries. The functional implications of these adaptive changes are considered. Received 13 February 2009; accepted 3 September 2009. [source]

Diagnosing acute lung injury in the critically ill: a national survey among critical care physicians

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2009
A. P. J. VLAAR
Background: Incidence reports on acute lung injury (ALI) vary widely. An insight into the diagnostic preferences of critical care physicians when diagnosing ALI may improve identification of the ALI patient population. Methods: Critical care physicians in the Netherlands were surveyed using vignettes involving hypothetical patients and a questionnaire. The vignettes varied in seven diagnostic determinants based on the North American European Consensus Conference and the lung injury score. Preferences were analyzed using a mixed-effects logistic regression model and presented as an odds ratio (OR) with a 95% confidence interval. Results: From 243 surveys sent to 30 hospitals, 101 were returned (42%). ORs were as follows: chest X-ray consistent with ALI: OR 1.7 (1.3,2.3), high positive end-expiratory pressure (PEEP) (15 cmH2O): OR 5.0 (3.9,6.6), low pulmonary artery occlusion pressures (PAOP) (<18 mmHg): OR 4.7 (3.6,6.1), low compliance (30 ml/cmH2O): OR 0.7 (0.5,0.9), low PaO2/FiO2 (<250 mmHg): OR 9.2 (6.9,12.3), absence of heart failure: OR 1.2 (0.9,1.5), presence of a risk factor for ALI (sepsis): OR 1.0 (0.8,1.3). The questionnaire revealed that critical care physicians with an anesthesiology background differed from physicians with an internal medicine background with regard to hemodynamic variables when considering an ALI diagnosis (P<0.05). Conclusions: Dutch critical care physicians consider the PEEP level, but not the presence of a risk factor for ALI, as an important factor to diagnose ALI. Background specialty of critical care physicians influences diagnostic preferences and may account for variance in the reported incidence of ALI. [source]

Examining antisocial behavior through the lens of the five factor model of personality

AGGRESSIVE BEHAVIOR, Issue 6 2003
Joshua D. Miller
The current study attempts to provide greater precision in understanding how personality is related to antisocial behavior. Specifically, we examined the relations between the facets (subordinate traits) from three domains (superordinate dimensions): Neuroticism, Agreeableness, and Conscientiousness, of the Five Factor Model and five outcome variables: stability of conduct problems, variety of conduct problems, onset of conduct problems, aggression, and antisocial personality disorder symptoms. These relations were examined in a community sample of 481 individuals. These three personality dimensions were chosen for exploration due to their consistent relations, at the domain level, with antisocial behaviors. The results from this study suggest that the facets from the dimension of Agreeableness are the most consistently related to all five outcomes. However, the facets from all three domains made significant contributions. Overall, three personality traits stood out as being the strongest and most consistent predictors: low straightforwardness, low compliance, and low deliberation. Implications for prevention and intervention are discussed. Aggr. Behav. 29:497,514, 2003. © 2003 Wiley-Liss, Inc. [source]

Prevalence and mechanism of bladder dysfunction in Guillain,Barré Syndrome,

NEUROUROLOGY AND URODYNAMICS, Issue 5 2009
Ryuji Sakakibara
Abstract Aim To examine the prevalence and mechanism of urinary dysfunction in GBS. Methods Urinary symptoms were observed and neurological examinations made repeatedly during hospitalization of 65 consecutive patients with clinico-neurophysiologically definite GBS. The patients included 41 men, 24 women; mean age, 41 years old; mean Hughes motor grade, 3; AIDP, 28, AMAN, 37. Urodynamic studies consisted of uroflowmetry, measurement of post-micturition residuals, medium-fill water cystometry, and external anal sphincter electromyography. Results Urinary dysfunction was observed in 27.7% of GBS cases (urinary retention, 9.2%). Urinary dysfunction was related to the Hughes motor grade (P,<,0.05), defecatory dysfunction (P,<,0.05), age (P,<,0.05), and negatively related to serum IgG class anti-ganglioside antibody GalNAc-GD1a (P,<,0.05). Urinary dysfunction was more common in AIDP (39%) than in AMAN (19%). No association was found between antibody titer against neuronal nicotinic acetylcholine receptors and urinary dysfunction. Urodynamic studies in nine patients, mostly performed within 8 weeks after disease onset, revealed post-void residual in 3 (mean 195 ml), among those who were able to urinate; decreased bladder sensation in 1; detrusor overactivity in 8; low compliance in 1; underactive detrusor in 7 (both overactive and underactive detrusor in 5); and nonrelaxing sphincter in 2. Conclusion In our series of GBS cases, 27.7% of the patients had urinary dysfunction, including urinary retention in 9.2%. Underactive detrusor, overactive detrusor, and to a lesser extent, hyperactive sphincter are the major urodynamic abnormalities. The underlying mechanisms of urinary dysfunction appear to involve both hypo- and hyperactive lumbosacral nerves. Neurourol. Urodynam. 28:432,437, 2009. © 2009 Wiley-Liss, Inc. [source]

Cuff compliance of pediatric and adult cuffed tracheal tubes: an experimental study

PEDIATRIC ANESTHESIA, Issue 8 2004
J.-M. Devys MD
Summary Background :,Tracheal mucosal damage related to tracheal intubation has been widely described in pediatric and adult patients. High volume,low pressure cuffs (HVLPC) are being advertised as safe to avoid this particularly unpleasant complication. Compliances of these supposed pediatric and adult HVLPC are not mentioned by manufacturers and still remain unknown. Methods :,The compliance of HVLPC was measured in vitro and defined as the straight portion of the pressure,volume curve. Cuff pressure was measured after incremental 0.1 ml filling volumes of air for sizes 3.0,8.0 of internal diameter of RüschTM and MallinckrodtTM tracheal tubes. Compliances were assessed in air and in a rigid tube. The filling volume to achieve a 25-mmHg intracuff pressure was also measured. Results :,In air, each 0.1 ml step almost linearly increased cuff pressure by 1 mmHg (size 8.0) to 9 mmHg (size 3). In air, the volume needed to maintain a cuff pressure < 25 mmHg was small for sizes 3,5.5 (0.35,2 ml). The 25 mmHg inflated cuff volume and compliance were decreased within a rigid tube, especially for adult sizes. In a rigid tube simulating a trachea, the compliances of almost every RüschTM tracheal tube were statistically higher than those of the MallinckrodtTM. Conclusion :,We conclude that the tested tracheal tube cuffs have low compliance and cannot be defined as high volume,low pressure. [source]

Sunburns, Sun Protection and Indoor Tanning Behaviors, and Attitudes Regarding Sun Protection Benefits and Tan Appeal among Parents of U.S. Adolescents,1998 Compared to 2004

PEDIATRIC DERMATOLOGY, Issue 1 2010
Priti Bandi M.S.
Data were from the American Cancer Society Sun Surveys I and II, telephone-based random digit dialed cross-sectional surveys of U.S. adolescents and their parents conducted in the summers of 1998 and 2004. Between 1998 and 2004, use of sunscreen, wide-brimmed hats and composite use of three to five behaviors increased significantly; concurrently, indoor tanning use increased significantly and sunburn prevalence changed a little. In 2004, 47% reported summer sunburns and more than half of those received painful sunburns. Parents continued to report low compliance with recommended behaviors; sunscreen use was most frequently reported, but many followed inappropriate application practices. About 13% practiced indoor tanning in the past year. Parents reported high levels of positive attitudes toward sun protection benefit, but at the same time, significant proportions reported positive tan appeal and outdoor sun exposure attitudes. The low rates and mixed progress in safe ultraviolet radiation exposure behaviors demand more attention for primary skin cancer prevention among parents of adolescents that focuses on changing beliefs about tanning appeal and promotes comprehensive ultraviolet radiation exposure protection. [source]

Transplant Outcomes and Economic Costs Associated with Patient Noncompliance to Immunosuppression

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 11 2009
B. W. Pinsky
We describe factors associated with immunosuppression compliance after kidney transplantation and examine relationships between compliance with allograft outcomes and costs. Medicare claims for immunosuppression in 15 525 renal transplant recipients with at least 1 year of graft function were used to calculate compliance as medication possession ratio. Compliance was categorized by quartiles as poor, fair, good and excellent. We modeled adjusted associations of clinical factors with the likelihood of persistent compliance by multiple logistic regressions (aOR), and estimated associations of compliance with subsequent graft and patient survival with Cox proportional hazards (aHR). Adolescent recipients aged 19,24 years were more likely to be persistently noncompliant compared to patients aged 24,44 years (aOR 1.49 [1.06,2.10]). Poor (aHR 1.80 [1.52,2.13]) and fair (aHR 1.63[1.37,1.93]) compliant recipients were associated with increased risks of allograft loss compared to the excellent compliant recipients. Persistent low compliance was associated with a $12 840 increase in individual 3-year medical costs. Immunosuppression medication possession ratios indicative of less than the highest quartile of compliance predicted increased risk of graft loss and elevated costs. These findings suggest that interventions to improve medication compliance among kidney transplant recipients should emphasize the benefits of maximal compliance, rather than discourage low compliance. [source]