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One Year (one + year)
Kinds of One Year Terms modified by One Year Selected AbstractsHealth Status among Emergency Department Patients Approximately One Year after Consecutive Disasters in New York CityACADEMIC EMERGENCY MEDICINE, Issue 10 2005William George Fernandez MD Abstract Objectives: Emergency department (ED) patients with disaster-related experiences may present with vague symptoms not clearly linked to the event. In 2001, two disasters in New York City, the World Trade Center disaster (WTCD) and the subsequent American Airlines Flight 587 crash, presented an opportunity to study long-term consequences of cumulative disaster exposure (CDE) on health-related quality of life (HRQOL) among ED patients. Methods: From July 15 to October 30, 2002, a systematic sample of stable, adult patients from two EDs in New York City were enrolled. Participants completed a self-administered questionnaire. The Short Form 36 (SF-36) was used to assess overall health status. Bivariate analyses were conducted to identify individual correlates of worsening health status. Multivariate regression was performed to identify the association between various factors and overall health status, while controlling for relevant sociodemographic variables. Results: Four hundred seventy-one patients (54.6% female) participated. The participation rate was 73.4%. One hundred sixty-one participants (36%) reported direct, indirect, or occupational exposure to the WTCD; 55 (13.3%) had direct, indirect, or occupational exposure to the plane crash; 33 (8.1%) had both exposures. In separate multivariate models, CDE predicted lower SF-36 scores for general health (p < 0.0096), mental health (p < 0.0033), and bodily pain (p < 0.0046). Conclusions: In the year following mass traumatic events, persons with CDE had lower overall health status than those with one or no disaster exposure. Clinicians should consider the impact that traumatic events have on the overall health status of ED patients in the wake of consecutive disasters. [source] Children with Complex Mental Health Problems: Needs, Costs and Predictors over One YearCHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2005Andrew F. Clark Background:, Little is known regarding children of greatest concern with complex mental health problems. Method:, A one-year prospective study of psychiatric diagnosis, psychosocial functioning, need status and service receipt in 60 children identified as most concerning. Results:, Thirty-two (53%) had two or more disorders. The mean number of needs per child was five. One year later mean needs were unchanged but with considerable individual variation. Mean weekly costs were £1017 (,1627) (SD = £957 (,1531)). Higher costs related to social factors rather than diagnosis or need. Conclusions:, The mean annual cost of services to children with complex mental health problems is ten times that in other studies of children with mental health problems. [source] Odontoma-like malformation in a permanent maxillary central incisor subsequent to trauma to the incisor predecessorDENTAL TRAUMATOLOGY, Issue 5 2005Paulo Nelson-Filho Abstract,,, This report describes a case of a patient (1 year and 8 months old) with traumatic avulsion of the maxillary right primary central incisor and morphological changes in the germ of the permanent successor. One year after the trauma, an odontoma-like malformation developed. This malformation was removed 6 years after trauma and orthodontic treatment was started. Clinical follow-up and periodic radiographs are necessary after traumatic avulsion of primary teeth to monitor possible sequelae in the permanent successor. An odontoma-like malformation requires a multidisciplinary approach. [source] Histological and Clinical Findings in Different Surgical Strategies for Focal Axillary HyperhidrosisDERMATOLOGIC SURGERY, Issue 8 2008FALK G. BECHARA MD INTRODUCTION Although a variety of different surgical strategies for focal axillary hyperhidrosis (FAH) have proven effective, little is known of intraoperative and postoperative histologies of different surgical methods. OBJECTIVE The objective was to use pre-, intra-, and postoperative histologic findings to evaluate different surgical procedures for FAH in establishing a possible correlation between the interventions and clinical outcome. MATERIAL AND METHODS A total of 40 patients underwent surgery with 15 undergoing liposuction-curettage (LC), 14 radical skin excision (RSE) with Y-plasty closure, and 11 a skin-sparing technique (SST). Before surgery, density and ratio of eccrine and apocrine sweat glands were evaluated with routine histology. Further biopsies were taken directly after surgery in the RSE and SST groups and 1 year postoperatively in all patients. Additionally, gravimetry was performed, side effects were documented, and patients were asked to evaluate the aesthetic outcome of the surgical method by using an analogue scale. RESULTS Preoperatively, the mean density of eccrine glands was 11.1/cm2 compared to 16.9/cm2 apocrine glands (apocrine/eccrine ratio, 1.6). Biopsy specimen directly after surgery showed remaining sweat glands in 7/15 (46.7%) LC patients and in 4/11 (36.4%) of the SST patients. One year after surgery, sweat gland density was significantly reduced in the LC (79.1%) and the SST (74.9%) groups. In the RSE group, only scar formation was present. Gravimetry showed significantly reduced sweat rates 12 months after surgery in all groups (LC, 66.4%; SST, 62.9%; RSE, 65.3% [p<.05]). Most frequent side effects were hematoma (LC, n=3; SST, n=2; RSE, n=3), subcutaneous fibrotic bridles (LC, n=8; SST, n=3; RSE, n=0), skin erosion (LC, n=3; SST, n=4; RSE, n=0), focal hair loss (LC, n=9; SST, n=11; RSE, n=14), and paresthesia (LC, n=4; SST, n=3; RSE, n=5). CONCLUSION Histologic distribution and density of sweat glands were comparable to previous studies. All three surgical procedures evaluated are effective in the treatment of FAH. RSE and SST techniques are associated with a higher risk of side effects and cause more extensive scarring. However, one LC patient (n=1; 6.7%) did not respond to treatment. [source] Acute encephalopathy with biphasic seizures and late restricted diffusion on MRI in a Japanese child living in the USADEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 9 2008David E Traul MD PhD We report an 18-month-old Japanese female living in the USA whose clinical course and radiographic findings were consistent with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). She was initially diagnosed with complex febrile seizures. However, on day 3 of admission, she had a cluster of complex partial seizures and the onset of a global developmental regression. In contrast to the normal magnetic resonance image of the brain obtained on admission, subsequent imaging demonstrated transient subcortical diffusion-weighted abnormalities in the white matter of the bilateral posterosuperior frontal, parietal, temporal, and occipital regions, with sparing of the perirolandic area. One year later, her developmental delay, although improved, persisted and she continued to experience sporadic seizures while being treated with topiramate monotherapy. Repeat imaging showed diffuse, poorly defined, increased T2 signals in the white matter of the posterosuperior frontal, parietal, temporal and occipital regions and diffuse cerebral volume loss. Previous reports of AESD have been limited to children aged under 4 years living in Japan. With the identification of this case, it is important that all physicians, not only those in Japan, who care for children with febrile seizures be aware of AESD and its associated neurological morbidity. [source] ENDOSCOPIC NECROSECTOMY UNDER DIRECT VISION AFTER ENDOSCOPIC ULTRASOUND-GUIDED CYSTGASTROSTOMY FOR ORGANIZED PANCREATIC NECROSISDIGESTIVE ENDOSCOPY, Issue 1 2008Takeshi Hisa A 56-year-old man was referred for an enlarging pancreatic pseudocyst that developed after severe acute pancreatitis with gallstones. Abdominal ultrasound showed a huge cystic lesion with a large amount of solid high echoic components. Arterial phase contrast-enhanced computed tomography scan revealed arteries across the cystic cavity. Stents were placed after endoscopic ultrasound-guided cystgastrostomy; however, the stents were obstructed by necrotic debris, and secondary infection of the pseudocyst occurred. Therefore, the cystgastrostomy was dilated by a dilation balloon, and a forward-viewing endoscope was inserted into the cystic cavity. Many vessels and a large amount of necrotic debris existed in the cavity. Under direct vision, all necrotic debris was safely removed using a retrieval net and forceps. One year after this procedure, there was no recurrence. Our case indicates that peripancreatic fat necrosis can cause exposure of vessels across/along the cystic cavity, and blind necrosectomy should be avoided. [source] Multi-generational effects of polybrominated diphenylethers exposure: Embryonic exposure of male American kestrels (Falco sparverius) to DE-71 alters reproductive success and behaviorsENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 8 2010Sarah C. Marteinson Abstract Polybrominated diphenylethers (PBDEs) are additive flame-retardants that are environmentally persistent and bioaccumulative compounds of particular concern to species at high trophic levels, including predatory birds. The developmental effects of in ovo exposure to male birds at environmentally relevant levels of the PBDE technical mixture, DE-71, on reproductive success and behaviors using captive American kestrels (Falco sparverius) were determined. Males were exposed in ovo by direct maternal transfer to DE-71 and unintentionally to low concentrations of hexabromocyclododecane (HBCD) at three mean,±,standard error DE-71 concentrations of 288.60,±,33.35,ng/g wet weight (low-exposure), 1130.59,±,95.34,ng/g wet weight (high-exposure), or background levels of 3.01,±,0.46,ng/g wet weight (control). One year following exposure, males were paired with unexposed females. Reproductive success was lower in the high exposure pairs: 43% failed to lay eggs while all other pairs laid complete clutches; they also laid smaller clutches and produced smaller eggs with reduced fertility, parameters that were negatively correlated with paternal in ovo concentrations of all PBDEs, as well as individual congeners and HBCD. Throughout courtship, there were fewer copulations by all in ovo exposed males, fewer mate-calls made by high-exposure males, and decreasing trends in pair-bonding and nest-box behaviors across treatments that continued during brood rearing. The reductions in clutch size and fertility were associated with the reduced frequencies of male courtship behaviors, and were associated with increasing concentrations of the PBDE congeners BDE-47, -99, -100, -53, -138, and HBCD. The results of the present study confirm effects noted in the F0 generation and demonstrate that exposure to DE-71 affects multiple generations of this predatory avian species at environmentally relevant levels of exposure. Environ. Toxicol. Chem. 2010; 29:1740,1747. © 2010 SETAC [source] Effect of organic carbon content, clay type, and aging on the oral bioavailability of hexachlorobenzene in rats,ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 11 2007Shakil A. Saghir Abstract Bioavailability of lipophilic chemicals is influenced by the physicochemical properties of soils/sediment such as particle size, pH, clay, and organic carbon content. The present study investigated the effects of sediment composition and aging on the oral bioavailability of hexachlorobenzene (HCB) in rats. Formulated sediments were prepared using various ratios of kaolinite and montmorillonite clay, sand, peat moss, and black carbon, spiked with 14C-HCB, and orally administered to rats prior to and after one year of aging in dark at 10°C. In the nonaged sediments there was a 21 to 45% reduction in the oral bioavailability of HCB when compared to the corn oil standard without any clear pattern of the impact of the sediment clay and/or organic carbon content. One year of aging resulted in statistically significant (p = 0.049) reduction in the oral bioavailability of HCB from the sediments compared to the corn oil standard and nonaged sediment indicating stronger interactions between HCB and sediment contents with aging. The mean reduction in oral bioavailability after one year of aging ranged from approximately 5 to 14% greater than that observed for nonaged sediments. The fecal elimination of the HCB-derived radioactivity from the one-year-aged sediments was much higher than the nonaged sediments, consistent with the lower absorption from the gastrointestinal tract due to lower desorption of HCB from the aged sediments. Increase in the fecal elimination and decrease in oral bioavailability of 14C-HCB was related to the increase in clay and black carbon. [source] Differential effects of temporal pole resection with amygdalohippocampectomy versus selective amygdalohippocampectomy on material-specific memory in patients with mesial temporal lobe epilepsyEPILEPSIA, Issue 1 2008Christoph Helmstaedter Summary Purpose: In the surgical treatment of mesial temporal lobe epilepsy, there is converging evidence that individually tailored or selective approaches have a favorable cognitive outcome compared to standard resections. There is, however, also evidence that due to collateral damage, selective surgery can be less selective than suggested. As part of a prospective transregional research project the present study evaluated the outcome in memory and nonmemory functions, following two selective approaches: a combined temporal pole resection with amygdalohippocampectomy (TPR+) and transsylvian selective amygdalohippocampectomy (SAH). Methods: One year after surgery, cognitive outcomes of postoperatively seizure-free patients with mesial TLE and hippocampal sclerosis, who underwent either TPR+ (N = 35) or SAH (N = 62) in two German epilepsy centers (Bonn/Berlin), were compared. Results: Repeated measurement MANOVA and separate post hoc testing indicated a double dissociation of verbal/figural memory outcome as dependent on side and type of surgery. Verbal memory outcome was worse after left-sided operation, but especially for SAH, whereas figural memory outcome was worse after right-sided operation, preferentially for TPR+. Attention improved independent of side or type of surgery, and language functions showed some improvement after right-sided surgeries. Discussion: The results indicate a differential effect of left/right SAH versus TPR+ on material-specific memory insofar as transsylvian SAH appears to be favorable in right and TPR+ in left MTLE. The different outcomes are discussed in terms of a different surgical affection of the temporal pole and stem, and different roles of these structures for verbal and figural memory. [source] Successful unrelated cord blood transplantation in a 7-year-old boy with Evans syndrome refractory to immunosuppression and double autologous stem cell transplantationEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2006Christian Urban Abstract:, Evans syndrome is an autoimmunopathy characterized by thrombocytopenia and autoimmune hemolytic anemia with poor response to immunosuppression. A 2-yr-old boy with Evans syndrome showed only short-lasting responses to immunosuppressive treatment including double autologous peripheral stem cell transplantation (SCT). Intracranial bleeding required emergency splenectomy and external ventricular drainage. Unrelated umbilical cord blood was given following conditioning with busulfan, thiotepa, etoposide and antithymocyte globulin. One year after SCT the patient shows stable blood counts without immunosuppression. This is the first child reported with Evans syndrome successfully treated by means of unrelated cord blood transplantation. [source] Rhizomorph production and stump colonization by co-occurring Armillaria cepistipes and Armillaria ostoyae: an experimental studyFOREST PATHOLOGY, Issue 1 2006S. Prospero Summary In managed spruce forests, Armillaria cepistipes and A. ostoyae are efficient stump colonizers and may compete for these resources when they co-occur at the same site. The aim of this experiment was to quantify the mutual competitive ability of the two Armillaria species in producing rhizomorphs and in colonizing Norway spruce (Picea abies) stumps. Five isolates of A. cepistipes and two isolates of A. ostoyae were simultaneously inoculated pair-wise into pots containing a 4-year-old spruce seedling. For comparison, each isolate was also inoculated alone. One year after inoculation, stumps were created by cutting down the seedlings. Six months after creation of the stumps, rhizomorph production and stump colonization were assessed. Armillaria spp. were identified from 347 rhizomorphs and 48 colonized stumps. Armillaria cepistipes dominated both as rhizomorphs in the soil and on the stumps. Nevertheless, A. ostoyae was relatively more frequent on the stumps than in the soil and A. cepistipes was relatively more frequent in the soil than on the stumps. In both species, the ability to colonize the stumps in simultaneous inoculations was significantly reduced compared with single inoculations. In respect to rhizomorph production, simultaneous co-inoculations had a slightly stimulatory effect on A. cepistipes and no significant effect on A. ostoyae. Our study suggests a rather neutralistic co-existence of A. cepistipes and A. ostoyae as rhizomorphs in the soil. Concerning the ability to colonize stumps, the two species experience a mutual negative effect from the interaction, probably because of interspecific competition. Résumé Dans les forêts gérées d'épicéas, Armillaria cepistipes et Armillaria ostoyae sont de bons colonisateurs de souches et sont en compétition pour cette ressource quand ils sont présents ensemble dans le même site. L'objectif de l'expérimentation était de quantifier l'aptitude compétitive mutuelle des deux espèces d'Armillaria pour la production de rhizomorphes et la colonisation de souches d'épicéa commun (Picea abies). Cinq isolats de A. cepistipes et deux isolats de A. ostoyae ont été inoculés simultanément par paires dans des pots contenant chacun un semis d'épicéa de 4 ans. Chaque isolat a également été inoculé seul, à titre de comparaison. Un an après inoculation, les semis ont été coupés pour créer des souches. Six mois après la coupe, la production de rhizomorphes et la coloniasation des souches ont été estimées. Armillaria spp. a été identifiéà partir de 347 rhizomorphes et 48 souches colonisées. A. cepistipes domine à la fois sous forme de rhizomorphes dans le sol et dans les souches. Toutefois, A. ostoyae est relativement plus fréquent sur souches que dans le sol alors que l'inverse est observé pour A. cepistipes. Pour les deux espèces, l'aptitude à coloniser les souches a significativement été réduite dans le cas des inoculations simultanées par rapport aux inoculations simples. En ce qui concerne la production de rhizomorphes, les inoculations simultanées ont eu un léger effet stimulant sur A. cepistipes et pas d'effet significatif sur A. ostoyae. Nos résultats suggèrent une co-existence relativement neutre entre A. cepistipes et A. ostoyaeà l'état de rhizomorphes dans le sol. Concernant l,aptitude à coloniser les souches, les deux espèces subissent un effet négatif mutuel de l'interaction, provenant probablement de la compétition interspécifique. Zusammenfassung In bewirtschafteten Fichtenwäldern sind Armillaria cepistipes und Armillaria ostoyae effiziente Besiedler von Baumstümpfen und sie können um diese Ressource miteinander konkurrieren, da sie häufig gemeinsam vorkommen. Es wurde ein Experiment durchgeführt mit dem Ziel, die wechselseitige Konkurrenzfähigkeit dieser beiden Armillariaarten bezüglich ihrer Rhizomorphenproduktion und ihrer Fähigkeit zur Besiedlung von Fichtenstümpfen (Picea abies) zu quantifizieren. Fünf Isolate von A. cepistipes und zwei Isolate von A. ostoyae wurden gleichzeitig paarweise in Töpfe mit einem vierjährigen Fichtensämling inokuliert. Zum Vergleich wurde jedes Isolat auch alleine inokuliert. Ein Jahr nach der Inokulation wurden durch Abschneiden der Pflanzen Stümpfe erzeugt. Sechs Monate nach dem Schnitt wurde die Rhizomorphenproduktion und die Besiedelung der Stümpfe erfasst. Die beiden Arten wurden aus 347 Rhizomorphen und 48 besiedelten Stümpfen reisoliert. Armillaria cepistipes dominierte sowohl in Form von Rhizomorphen im Boden als auch in den Stümpfen. Armillaria ostoyae kam häufiger in den Stümpfen vor als im Boden und A. cepistipes wurde häufiger im Boden gefunden als in den Stümpfen. Bei beiden Arten war die Fähigkeit zur Stumpfbesiedelung bei gleichzeitiger Inokulation im Vergleich zur Einzelinokulation signifikant reduziert. Die gleichzeitige Inokulation mit beiden Arten stimulierte die Rhizomorphenproduktion bei A. cepistipes leicht, hatte aber keinen signifikanten Einfluss auf A. ostoyae. Diese Befunde deuten auf eine weitgehend neutrale Koexistenz der Rhizomorphen von A. cepistipes und A. ostoyae im Boden hin, bezüglich ihrer Fähigkeit zur Stumpfbesiedelung hemmen sich beide Arten aber gegenseitig. Dieser Effekt ist wahrscheinlich durch interspezifische Konkurrenz zu erklären. [source] Functional results with advanced hypopharyngeal carcinoma treated with circular near-total pharyngolaryngectomy and jejunal free-flap repairHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 1 2006Stephane Temam MD Abstract Background. Patients treated by a circular pharyngolaryngectomy for advanced hypopharyngeal carcinoma have a poor prognosis and disappointing speech restoration. Methods. Three carefully selected patients underwent a near-total laryngectomy circular pharyngectomy with jejunal free flap repair and dynamic tracheopharyngeal shunt for treatment of advanced hypopharyngeal carcinoma. They received induction chemotherapy and postoperative radiotherapy. We assessed the functional outcome. Results. There was no major local complication. One year after the end of radiotherapy, all patients were able to eat solid diets. Two patients were able to speak immediately after the end of the treatment. After speech re-education, a high-quality tracheopharyngeal voice was restored in all three patients. Performance Status Scale for Head and Neck Cancer Patients (PSSHN) showed a mean score equal to 81/100 at 1 year. Conclusions. In selected patients, near-total laryngectomy circular pharyngectomy with tracheopharyngeal shunt and jejunal free-flap repair offers good voice rehabilitation without impairing swallowing function. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B,,HEPATOLOGY, Issue 3 2010Ting-Tsung Chang One year of treatment with entecavir (0.5 mg daily) in nucleoside-naive patients with hepatitis B e antigen (HBeAg)-positive or HBeAg-negative chronic hepatitis B (CHB) resulted in significantly improved liver histology and virological and biochemical endpoints in comparison with lamivudine. Patients who received at least 3 years of cumulative entecavir therapy in phase 3 studies and a long-term rollover study and underwent long-term liver biopsy were evaluated for improvements in histological appearance. Sixty-nine patients [50 HBeAg-positive and 19 HBeAg-negative] receiving entecavir therapy underwent long-term liver biopsy (median time of biopsy = 6 years, range = 3-7 years). Histological improvement was analyzed for 57 patients who had adequate baseline biopsy samples, baseline Knodell necroinflammatory scores ,2, and adequate long-term biopsy samples. At the time of long-term biopsy, all patients in the cohort had a hepatitis B virus DNA level <300 copies/mL, and 86% had a normalized alanine aminotransferase level. Histological improvement (,2-point decrease in the Knodell necroinflammatory score and no worsening of the Knodell fibrosis score) was observed in 96% of patients, and a ,1-point improvement in the Ishak fibrosis score was found in 88% of patients, including all 10 patients with advanced fibrosis or cirrhosis at the phase 3 baseline. Conclusion: The majority of nucleoside-naive patients with CHB who were treated with entecavir in this long-term cohort achieved substantial histological improvement and regression of fibrosis or cirrhosis. (HEPATOLOGY 2010) [source] A cool response to the ICE Regulations?INDUSTRIAL RELATIONS JOURNAL, Issue 5 2006Employer, consultation, trade union approaches to the new legal framework for information ABSTRACT One year on from the introduction of the Information and Consultation of Employees Regulations, this article reviews the emerging patterns of implementation in the light of the legislation's ,reflexive' design. The available evidence suggests considerable employer-led activity in terms of reviewing, modifying and introducing information and consultation arrangements but a relative paucity of formal ,pre-existing agreements', despite the protection they offer against the Regulations' statutory procedures being invoked by employees. This picture is consistent with a ,risk assessment' rather than a ,compliance' approach by management, facilitated by union ambivalence towards the legislation and low use of its provisions by employees. [source] Cutaneous sarcoid-like granulomas with alveolar hemorrhage and c-ANCA PR-3INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2004Natividade Rocha MD A 28-year-old woman, employed as a leather factory worker, noted asymptomatic, well-delimited plaques on both knees, 6 years ago. The plaques were violaceous with a smooth surface. One appeared over a post-traumatic scar from childhood (Fig. 1). Two years later, she began to complain of symptoms suggestive of polyarthritis, first of the small joints of the hands (proximal interphalanges) and then of the larger joints (wrists, elbows, and knees). She was diagnosed with rheumatoid arthritis and began treatment with nonsteroidal anti-inflammatory drugs for 1 month without any change. Deflazacort, 12 mg/day, and hydroxychloroquine, 400 mg/day, were administered for 3 months, with improvement of her articular complaints, but not her skin lesions. Figure 1. Well-delimited, violaceous plaques with a smooth surface on the knees, one over an old post-traumatic scar One year later, she complained of dysphonia, which remitted spontaneously after some weeks. After one additional year, she noted papules, with similar characteristics to the plaques, on the elbows, and two well-delimited orange-to-brown plaques on the forehead (Fig. 2). Figure 2. Orange,brown plaques symmetrically placed on the forehead During the fifth year of the disease, she was referred for the first time to a dermatologist, who biopsied one of the knee lesions. The histologic result was compatible with "sarcoid granuloma." At that time, she presented with skin lesions as her only complaint. Sarcoidosis was suspected based on a chest X-ray, which revealed hilar lymphadenopathy and diffuse accentuation of the interstitium. In November 2000, she suddenly developed fever (40 °C), cough with hemoptysis, dysphonia, and subcutaneous nodules on the palmar surface of the fingers of both hands that were painless, well-delimited, 5 mm in diameter, and firm (Fig. 3). She reported a weight loss of 12 kg in the previous 3 months. Pulmonary condensation was found on auscultation, and she had palpable hepatomegaly. Peripheral lymphadenopathy was not present. Figure 3. Painless, well-delimited, firm subcutaneous nodules on the palmar surface of the fingers Laboratory investigations revealed normochromic, normocytic anemia (hemoglobin, 7.7 g/dL), iron deficit, a white blood cell count of 16,000/µL with neutrophilia, an erythrocyte sedimentation rate of 130 mm/h, elevation of liver enzymes, a slight increase in angiotensin-converting enzyme (ACE) level (72 U/L), hypergammaglobulinemia (IgG, 3350 mg/dL), antinuclear antibody (ANA) of 1 : 320, and a slight increase in CD4 and decrease in CD8 lymphocytes with normal cellular morphology in blood. Renal function, urine sediment, urine and serum calcium, complement (C4), dsDNA, antimitochondrial antibody, direct and indirect Coombs test, antineutrophil cytoplasmic antibody (ANCA), tuberculin skin tests, viral markers of hepatitis B, C, and human immunodeficiency virus (HIV), electrocardiogram (ECG), ophthalmic examinations, and culture for infectious agents in blood and sputum were all normal or negative. Computed tomography (CT) scan showed an infiltrate in the upper right pulmonary lobule with a central cavity and bilateral hilar lymphadenopathy (Fig. 4). Homogeneous hepatosplenomegaly was present. The bronchoalveolar lavage (BAL) showed a slight lymphocytic increase predominantly of CD8 cells and hemosiderosis. Stains for infectious agents, including acid-fast bacillus, fungi, Mycoplasma, and Legionella, were negative. Three biopsies from the forehead, elbows, and knees showed well-formed noncaseating epithelioid cell granulomas with giant cells of the Langhans type in the dermis, suggestive of sarcoidosis (Figs 5 and 6). A fourth biopsy from a finger nodule demonstrated inflammatory infiltration of the dermis and necrosis with cellular debris. Vasculitis was not seen (Fig. 7). Figure 4. Computed tomography scan showing an infiltrate in the upper right pulmonary lobule with a central cavity Figure 5. Beneath a flattened epidermis, several sarcoid granulomas composed of epithelioid histiocytes and several multinucleated giant cells of Langhans type can be seen (hematoxylin and eosin, ×10) Figure 6. Less well-formed sarcoid granulomas in a hyperkeratotic area, surrounded by a sparse rim of lymphocytes (hematoxylin and eosin, ×20) Figure 7. Foci of necrosis and fibrinoid degeneration with some neutrophil infiltration and nuclear dusting (hematoxylin and eosin, ×40) The patient was treated with a broad-spectrum empirical antimicrobial (levofloxacin, 500 mg daily intravenously) over 12 days, with prompt improvement in her symptoms and remission of the forehead and finger lesions. Nevertheless, on the first evaluation after hospitalization, the CT scan showed persistence of the pulmonary cavity (Fig. 8). A repeat ANCA determination was positive (cytoplasmic pattern, c-ANCA) at 1 : 640 by indirect immunofluorescence (IIF). Antiproteinase-3 antibody was demonstrated at 78 by enzyme-linked immunosorbent assay (ELISA). Figure 8. Computed tomography scan showing persistence of the pulmonary cavity She underwent an open lung biopsy which revealed intra-alveolar hemorrhage and scanty noncaseating epithelioid cell granulomas of the sarcoidosis type in the peripheral blood vessels without vasculitis. A diagnosis of Wegener's granulomatosis was made and she began prednisolone (1 mg/kg/day) and oral cyclophosphamide (2 mg/kg/day). One year later, she is asymptomatic, the skin lesions have completely remitted, c-ANCA is negative, and the CT scan shows partial regression of the pulmonary cavity. [source] Metastatic cutaneous leiomyosarcoma from primary neoplasm of the mesenteryINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2001Kyoung Jin Kim MD A 31-year-old South Korean woman was referred to the dermatology department from the oncology department for the evaluation of a subcutaneous nodular lesion on the back. Three years before, she noted a palpable, fingertip-sized, nontender mass on her right lower abdomen. The mass had increased in size slowly. One year ago, she visited a local clinic and physical examination revealed a 7 × 8 × 7 cm, slightly tender, deep-seated mass on the right lower quadrant of the abdomen. The mass on the ilial mesentery was resected by surgical exploration and tissue examination revealed leiomyosarcoma. She refused adjuvant chemotherapy. Approximately 3 months later, she re-visited the clinic with a tender, subcutaneous nodule on the back. Cutaneous examination revealed a solitary, 2 × 2 cm, well-defined, hard, movable, subcutaneous nodule on the upper back without skin color change (Fig. 1). She complained of tenderness on touching the lesion. Histologic examination of a biopsy specimen showed irregularly arranged spindle cells scattered throughout the dermis. They were arranged in haphazardly oriented or interweaving fascicles. Most of the spindle cells possessed elongated nuclei with blunt ends and some cells had a polygonal outline with irregularly shaped nuclei (Fig. 2). There were many mitoses: 3,4 per high-power (× 400) field. Immunohistochemically, smooth muscle actin and desmin were positive in most of the tumor cells (Fig. 3). S-100 reactivity was not observed. A diagnosis of metastatic leiomyosarcoma was made. About 1 month later, computed tomography showed two, ill-defined, heterogeneous, low attenuation masses in the right lobe of the liver, suggesting liver metastasis. The patient was treated with chemotherapy for 2 months and remains in good condition. Figure 1. 2 × 2 cm, solitary, well-defined, hard, movable, subcutaneous nodule without any overlying skin change Figure 2. (a) Characteristic findings of cutaneous leiomyosarcoma with markedly high cellularity and densely packed transverse and longitudinal fascicles of cells (hematoxylin and eosin, × 40). (b) High magnification of the neoplasm revealing spindle cells with blunt-ended nuclei, pleomorphism, and mitotic figures (hematoxylin and eosin, × 200) Figure 3. Dense cytoplasmic reactivity for smooth muscle actin is apparent (smooth muscle actin, × 200) [source] Mucous membrane pemphigoid, thymoma, and myasthenia gravisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2000Haideh Yazdani Sabet In November 1997, approximately 1 year before being evaluated at the Mayo Clinic, Rochester, a 63-year-old woman presented with erosive tongue lesions that were diagnosed by her physician as oral lichen planus. The lesions responded well to 3 months of treatment with systemic and topical corticosteroids and topical antiyeast medication. She stopped taking the medications and had a relapse. A few months after the oral lesions developed, her left eyelid became ptotic. Results of magnetic resonance imaging of her brain were normal, and the ptosis resolved spontaneously after 2 weeks. One year later, her right eyelid began to droop, and the results of edrophonium testing were positive. She was prescribed prednisone, 30 mg daily, and pyridostigmine, as needed. The ptosis improved, but never fully resolved. Radiography revealed a left ,,thyroid nodule,'' but computed tomography did not show a mediastinal mass. She was advised to have the ,,nodule'' removed surgically and came to the Mayo Clinic, Rochester, for a second opinion. Her medical history was significant for the following: tinnitus, glaucoma, early bilateral cataracts, and long-standing hypertension, for which she took losartan, 50 mg twice daily. Other medications included: prednisone, 30 mg daily; pyridostigmine as needed; famotidine, 40 mg daily; and eyedrops for glaucoma. She denied any history of hyperthyroidism or hypothyroidism, head and neck irradiation, family history of thyroid disease, or diplopia. Hepatitis serologic studies revealed hepatitis B exposure and recovery, hepatitis C immunity, and a previous hepatitis A viral infection. On examination at the Mayo Clinic, Rochester, an erosive hypertrophic plaque was noted on the posterior dorsal half of the tongue, and vesicles and erythematous erosions on the hard and soft palates ( Fig. 1a). A lace-like white pattern was seen on the buccal mucosa bilaterally, and a small erosive patch on the left buccal mucosa ( Fig. 1b). Ocular and nasal mucous membranes were normal in appearance, and there were no pertinent skin findings. Dermatopathologic examination of an excisional biopsy specimen from the left dorsum of the tongue demonstrated an ulcer with epitheliomatous hyperplasia and a granulomatous reaction, presumably due to yeast infection. Silver staining showed hyphae and yeast at the base of the tongue ulcer. The results of the direct immunofluorescence study were negative and revealed no lichenoid changes on hematoxylin and eosin staining. Indirect immunofluorescence testing of the serum revealed a 1 : 80 titer of basement membrane zone antibodies, reflecting pemphigoid. This test was positive on repeat study. Salt-split skin on monkey esophagus revealed an epidermal pattern of basement membrane zone antibodies. Treatment included fluocinonide gel applied to the involved areas four times daily and oral antiyeast therapy (fluconazole, 200 mg once daily by mouth) while the rest of the evaluation was being completed. Figure 1(a). Erosive hypertrophic tongue plaque. Figure (b) ,. Erosive patch on the buccal mucosa. As part of the evaluation of the ptosis, a myasthenia gravis antibody panel was performed. It revealed the following abnormalities: striated muscle antibody at 1 : 480 (reference range, <1 : 60), acetylcholine receptor binding antibody at 6.33 nmol/L (reference range, ,,0.02 nmol/L), acetylcholine receptor blocking antibody at 31% (reference range, 0,25%), and acetylcholine receptor modulating antibody at 100% (reference range, 0,20%), suggesting thymoma. Treatment included pyridostigmine, 30,45 mg 3,4 times daily, to control the myasthenia symptoms, while the ill-defined neck mass was being evaluated. A mildly enlarged thyroid was noted on physical examination. Hematology panel revealed thyroid-stimulating hormone (TSH) levels in the low normal range; the thyroid microsomal antibody was normal. Chest radiography showed minor tracheal deviation, and a previous computed tomogram showed what appeared to be a 3-cm enlarged mass in the thyroid. Ultrasonographically guided thyroid biopsy did not show malignancy, but a benign mesenchymal-type tumor was found and surgical excision was planned. Intraoperatively, a thymoma of the left cervical thymic tongue was found. At 6 months' follow-up, the ptosis and oral mucosal lesions had improved significantly, although she continued topical corticosteroid therapy intermittently for minor erosive oral disease. [source] Solitary metastasis of renal cell carcinoma to the parotid gland 10 years after radical nephrectomyINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2004ATAY GÖ Abstract, Renal cell carcinoma metastasis to the parotid gland after tumor nephrectomy is extremely rare. We report a case of solitary parotid metastasis from clear cell renal cell carcinoma in a 59-year-old woman, who presented 10 years after primary treatment. To our knowledge this is the first case in the published literature presenting with solitary parotid metastasis after such a long time. Superficial parotidectomy with preservation of the facial nerve was performed. One year after, the patient developed contralateral multiple kidney tumors and underwent left radical nephrectomy. She is currently on a dialysis program and no additional metastasis has been observed for 18 months. [source] Clinical, urodynamic and endoscopic characteristics of the Stanford pouch ileal neobladder constructed with absorbable staplesINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2000M Cemil Uygur Abstract Purpose The clinical, urodynamic and endoscopic aspects of the Stanford pouch ileal neobladder formed with absorbable staples were investigated. Methods A Stanford pouch ileal neobladder was formed using absorbable staples after radical cystoprostatectomy in 30 male patients with the diagnosis of muscle invasive carcinoma of the bladder between 1995 and 1998. The mean age of the patients was 62 (range 41,70) years. Patients were followed with arterial blood gas, serum biochemistry, pouch cystography, urodynamic tests and endoscopy. Results Five (16.7%) patients had early postoperative complications and three were related to the neobladder. One year postoperatively, low grade (I, II) vesicoureteral reflux was present in five (16.7%) cases. The mean preoperative and 6 months postoperative serum creatinine levels were 1.07 ± 0.3 mg/dL and 1.2 ± 0.4 mg/dL, respectively, but the difference was not statistically significant (P = 0.1). Six months postoperatively the mean serum chloride level was 109 ± 4.5 (range 100,113) mmol/L and the mean arterial blood pH was 7.37 ± 0.2 (range 7.3,7.4). Two (6.7%) patients required oral alkaline supplementation because of high chloride levels. All the patients except one were continent throughout the day after 1 year. However, nocturnal enuresis was present in 25 (83.3%) cases. The pouch capacity was increased gradually up to 12 months postoperatively and the mean pouch capacity 12 months postoperatively was 460 ± 95.8 mL. Micturition occurred spontaneously in most patients while some needed abdominal straining. None of the patients had a residual urine of more than 60 mL. The mean maximum flow rate 6 months postoperatively was 9.8 (range 5.4,15.0) mL/s. After 6 months the stapled edge was noticed as a nodular line. One year postoperatively only a white scar could be observed at the suture line. Conclusion The Stanford pouch ileal neobladder constructed using absorbable staples was able to provide a good capacity,low pressure reservoir with a low rate of complications. [source] Implementing a pre-operative checklist to increase patient safety: a 1-year follow-up of personnel attitudesACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2010L. NILSSON Background: The operating room is a complex work environment with a high potential for adverse events. Protocols for perioperative verification processes have increasingly been recommended by professional organizations during the last few years. We assessed personnel attitudes to a pre-operative checklist (,time out') immediately before start of the operative procedure. Methods: ,Time out' was implemented in December 2007 as an additional safety barrier in two Swedish hospitals. One year later, in order to assess how the checklist was perceived, a questionnaire was sent by e-mail to 704 persons in the operating departments, including surgeons, anesthesiologists, operation and anesthetic nurses and nurse assistants. In order to identify differences in response between professions, each alternative in the questionnaire was assigned a numerical value. Results: The questionnaire was answered by 331 (47%) persons and 93% responded that ,time out' contributes to increased patient safety. Eighty-six percent thought that ,time out' gave an opportunity to identify and solve problems. Confirmation of patient identity, correct procedure, correct side and checking of allergies or contagious diseases were considered ,very important' by 78,84% of the responders. Attitudes to checking of patient positioning, allergies and review of potential critical moments were positive but differed significantly between the professions. Attitudes to a similar checklist at the end of surgery were positive and 72,99% agreed to the different elements. Conclusion: Staff attitudes toward a surgical checklist were mostly positive 1 year after their introduction in two large hospitals in central Sweden. [source] Reduced oxidative stress in parallel to improved cardiac performance one year after selective removal of anti-beta 1-adrenoreceptor autoantibodies in patients with idiopathic dilated cardiomyopathy: data of a preliminary study,JOURNAL OF CLINICAL APHERESIS, Issue 3 2005Ingolf Schimke Abstract Patients with idiopathic dilated cardiomyopathy (IDC) were treated with selective immunoadsorption to remove anti-beta 1-adrenoreceptor autoantibodies (anti-beta1A-AB). After one year, the effect on cardiac performance and oxidative stress was tested. Extracorporeal immunoadsorption of the whole IgG class in IDC patients for the removal of anti-beta1A-AB reduced oxidative stress in parallel to an improvement of cardiac performance. However, the non-specificity of IgG adsorption means that these beneficial effects cannot be attributed exclusively to anti-beta1A-AB removal. In an open clinical pilot study enrolling 8 patients with IDC prior to and one year after selective immunoadsorption of anti-beta1A-AB, plasma markers for oxidative stress,thiobarbituric acid-reactive substances (TBARS), lipid peroxides (LPO) and anti-oxidized low-density lipoprotein autoantibodies (anti-oxLDL-AB),were measured in parallel to evaluation of the left ventricular function using conventional echocardiography and wall motion analysis by tissue Doppler imaging. After one year, TBARS (Wilcoxon test with bootstrapping simulation for paired data: 95% confidence interval of the P value 0.020 to 0.029) and anti-oxLDL-AB (P = 0.025 to 0.035) were decreased in parallel to an improvement of the peak systolic wall motion velocity (P = 0.006 to 0.01) and left ventricular ejection fraction (P = 0.002 to 0.02). For changes over the study period, a direct correlation with borderline significance (P = 0.076) was calculated for TBARS to the left ventricular diameter in the diastole. One year after selective immunoadsorption for anti-beta1A-AB removal, patients with ICD show a reduction in oxidative stress and a parallel improvement in cardiac performance. J. Clin. Apheresis © 2005 Wiley-Liss, Inc. [source] Clinical outcomes following treatment of human intrabony defects with GTR/bone replacement material or access flap aloneJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2004A multicenter randomized controlled clinical trial Abstract Aim: This prospective multicenter randomized controlled clinical trial was designed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of a guided tissue regeneration (GTR)/bone replacement material. Materials and Methods: One hundred and twenty-four patients with advanced chronic periodontitis were recruited in 10 centers in seven countries. All patients had at least one intrabony defect of 3 mm. The surgical procedures included access for root instrumentation using either the simplified or the modified papilla preservation flap in order to obtain optimal tissue adaptation and primary closure. After debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CALs), probing pocket depths (PPDs), recession, full-mouth plaque scores and full-mouth bleeding scores (FMBS) were assessed. Results: One year after treatment, the test defects gained 3.3±1.7 mm of CAL, while the control defects yielded a significantly lower CAL gain of 2.5±1.5 mm. Pocket reduction was also significantly higher in the test group (3.7±1.8 mm) when compared with the controls (3.2±1.5 mm). A multivariate analysis indicated that the treatment, the clinical centers, baseline PPD and baseline FMBS significantly influenced CAL gains. Odds ratios (ORs) of achieving above-median CAL gains were significantly improved by the test procedure (OR=2.6, 95% CI 1.2,5.4) and by starting with deeper PPD (OR=1.7, 1.3,2.2) but were decreased by receiving treatment at the worst-performing clinical center (OR=0.9, 0.76,0.99). Conclusions: The results of this trial indicated that regenerative periodontal surgery with a GTR/bone replacement material offers an additional benefit in terms of CAL gains, PPD reductions and predictability of outcomes with respect to papilla preservation flaps alone. [source] CASE REPORT: Hyperlipoproteinaemia(a): which is the optimal therapy?JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 5 2010A case report Summary This case report presents the clinical history of a patient with elevated lipoprotein(a) and small size isoform, associated with mixed hyperlipaemia, which was probably familial combined hyperlipaemia. After premature myocardial infarction, the subject was treated with fibrates. Niacin was started after recurrence. One year ago, after another episode of acute coronary syndrome, rosuvastatin was added to niacin. The atherogenicity of this lipid disorder, along with the different options for therapy is discussed. [source] Stress and well-being in the aftermath of the World Trade Center attack: The continuing effects of a communitywide disasterJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2005Richard E. Adams In this study, we examine the relationship between exposure to the World Trade Center disaster (WTCD) and the well-being of adults living in New York City (NYC) at the time of the attacks by using a stress process model. One year after the attacks, we conducted a telephone survey of a cross-sectional random sample of city residents with an oversample of residents who had received mental health treatment since the attacks (N = 2,368). The survey gathered information about respondents' demographic characteristics, exposure to the WTCD, other stressful events, and social psychological resources. The dependent variable (health status) was measured by using the Short Form-12 (SF-12) mental health and physical health scales. Overall, the greater the exposure to the events surrounding the WTCD, the poorer the person's psychological well-being, even after controlling for demographic characteristics, other stressors, and social psychological resources. Exposure was only weakly related to physical well-being, once other factors were taken into account. The findings clearly show that individuals who experienced greater exposure to the WTCD have more psychological problems than those who had less exposure 1 year after the attacks. Exposure did not seem to have such severe consequences for physical well-being. Thus, our study supports the continuation of mental health services to survivors of a community disaster well beyond the first year post disaster. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 175,190, 2005. [source] Primary Cutaneous Ewing's SarcomaJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005K.S. Draft A 57-year-old woman presented with a three-week history of an erythematous nodule on her palm. The clinical diagnosis was pyogenic granuloma. Histology revealed a circumscribed dermal nodule of uniform, primitive round cells with numerous mitotic figures and apoptopic cells. The tumor cells showed strong membranous immunoreactivity for CD99 and nuclear immunoreactivity for Fli-1. The tumor cells were negative for S-100 protein, cytokeratin AE1/3, cytokeratin 20, chromogranin, synaptophysin, and actin. The diagnosis of Ewing's sarcoma was made. CT scans showed no evidence of an osseous or deep soft tissue primary tumor or metastatic disease. The tumor was excised with 1 cm margins, and the patient received six courses of adjuvant chemotherapy. One year after diagnosis, the patient is alive without evidence of disease. Extraosseous Ewing's sarcoma (EES) rarely presents as a primary skin tumor and should be considered in the differential diagnosis of small round cell tumors involving the skin. It is important to distinguish primary cutaneous EES from secondary involvement of the skin by ES, as primary cutaneous EES has a more indolent course compared to classic EES or osseous ES. Immunohistochemical stains for CD99 and Fli-1 are useful markers to confirm the diagnosis of cutaneous ES. [source] One year done & moving onwardJOURNAL OF HOSPITAL MEDICINE, Issue 1 2007Mark Williams MD [source] The effect of three different periodontal pre-treatment procedures on the success of telescopic removable partial denturesJOURNAL OF ORAL REHABILITATION, Issue 4 2003R. Polansky summary, In this prospective study, 120 teeth consisting of maxillary and mandibular canines and premolars were divided into three groups each containing 40 teeth. The teeth were assigned randomly in quadrants to three different periodontal treatment protocols. The first group was treated with professional prophylaxis only. The second group received additional deep scaling. With the third group, additional surgical periodontal flap surgery and scaling was performed. Both papillary bleeding index (PBI) and probing depth (PD) were evaluated before, during and after treatment. During the subsequent prosthetic treatment phase all teeth were then used as telescope abutments supporting a removable prosthesis. The documentation of the attachment level (AL) was then used as a clinical parameter. One year after the incorporation of telescopic removable partial dentures (RPDs), PD, PBI and AL were again evaluated. The resulting periodontal parameters were compared between the different groups using the general linear model (GLM) repeated measures and the Kruskal,Wallis test for non-parametric variables. Differences within the three treatment groups were determined using the t -test, e.g. the Wilcoxon test for dependent variables (P < 0·05). A significant decrease in inflammatory indices (PBI) was found for all types of periodontal treatment (P < 0·03 for all groups). Additionally, the reduction in PD was significant for all of the three groups (P < 0·001 for all groups). The greatest reduction in PD was observed in the group in which a surgical approach was used. Evaluation of the attachment level after the incorporation of the telescopic RPDs showed that tooth position did not influence the periodontal prognosis and that the use of telescopic RPDs exerted no ascertainable negative influence on the periodontium of the abutment teeth. [source] Survival of Sclerotium cepivorum Sclerotia and Fusarium oxysporum Chlamydospores in Soil Amended with Cruciferous ResiduesJOURNAL OF PHYTOPATHOLOGY, Issue 6 2000U. SmolinskaArticle first published online: 28 JUN 200 Abstract The use of cruciferous plant residues to reduce the amount of sclerotia of Sclerotium cepivorum and chlamydospores of Fusarium oxysporum f. sp. lycopersici in soil was investigated. Air-dried and crushed mustard (Brassica juncea) added to the soil effectively reduced the viability of fungal propagules. Consequently, the reduction of white rot of onion, caused by S. cepivorum and wild of tomato caused by F. oxysporum was observed. The addition of rapeseed (Brassica. napus cv. Bolko and B. napus cv. Gorczanski) residues to soil also resulted in a significant decrease of number of S. cepivorum sclerotia but the effect on F. oxysporum chlamydospores was variable. Introduction of the plant material increased the total number of bacteria, spore-forming bacteria, fluorescent pseudomonads, actinomycetes, and fungi in soil. One year after the soil amendment, the amount of sporeforming bacteria in treatments with cruciferous residues was higher as compared to the control soil without plant residues. The possible contribution of the decomposition of plant residues and soil micro-organisms to the reduction of the pathogens population is discussed. Zusammenfassung Untersucht wurde die Eignung von Kreuzblütler-Pflanzenresten zur Reduktion der Zahl der Sklerotien von Sclerotium cepivorum und der Chlamydosporen von Fusarium oxysporum f. sp. lycopersici im Boden. Wurden luftgetrocknete und zerkleinerte Senfpflanzen (Brassica juncea) als Bodenzusatz verwendet, so war die Lebensfähigkeit der pilzlichen Überdauerungsorgane deutlich verringert. Entsprechend wurde ein Rückgang der durch S. cepivorum hervorgerufenen Weißfäule der Zwiebel und der durch F. oxysporum hervorgerufenen Tomatenwelke beobachtet. Der Zusatz von Raps-Pflanzenresten (Brassica napus cv. Bolko und B. napus cv. Gorczanski) zum Boden führte ebenfalls zu einer signifikanten Abnahme der Zahl von S.-cepivorum -Sklerotien, doch die Wirkung auf die Chlamydosporen von F. oxysporum war unterschiedlich. Die Einbringung des Pflanzenmaterials erhöhte die Gesamtzahl an Bakterien, sporenbildenden Bakterien, fluoreszierenden Pseudomonaden, Actinomyceten und Pilzen im Boden. Ein Jahr nach der Bodenanreicherung war die Zahl sporenbildender Bakterien in den Varianten mit Kreuzblütler-Resten höher als in den Böden der Kontrollvariante ohne Pflanzenreste. Der mögliche Einfluß der Zersetzung der Pflanzenreste und der Bodenmikroorganismen auf die Reduktion der Pathogenpopulation wird diskutiert. [source] Quality of life assessment of treatment with dental appliance or UPPP in patients with mild to moderate obstructive sleep apnoea.JOURNAL OF SLEEP RESEARCH, Issue 3 2000A prospective randomized 1-year follow-up study The objectives of this study were: to evaluate the change in the three quality of life (QOL) dimensions of vitality, contentment and sleep before intervention and 1 year after treatment with a dental appliance or uvulopalatopharyngoplasty (UPPP); to compare the effect of treatment between these two treatment groups on these three dimensions; and to determine the relation between the QOL scores and somnographic values. Ninety-five patients with mild to moderate obstructive sleep apnoea (OSA) (AI > 5) were randomly allocated to either a dental appliance or UPPP treatment group. Seven patients withdrew after randomization but before treatment, leaving 88 patients eligible for treatment. The patients were examined using somnography and administered the Minor Symptoms Evaluation-Profile (MSE-P), a QOL questionnaire, before and 1 year after intervention. Thirty-seven patients in the dental appliance group and 43 in the UPPP group completed the 1-year follow-up. The mean values for the three dimensions vitality, contentment and sleep improved significantly 1 year after intervention in the dental appliance and UPPP groups. No difference in the QOL scores at baseline was noted between the groups. One year after intervention the UPPP group showed significantly more contentment than the dental appliance group. In contrast, vitality and sleep dimensions did not differ between the two treatment groups. No significant correlations were observed between the QOL scores and somnographic values. In conclusion, quality of life improved significantly in the dental appliance and UPPP groups 1 year after intervention. However, the dental appliance group showed a lower level of contentment than the UPPP group, even though the somnographic values were superior in the former group. [source] Disaster mental health workers responding to ground zero: One year laterJOURNAL OF TRAUMATIC STRESS, Issue 2 2008Erin Scott Daly The current study examined anniversary reactions in mental health disaster relief workers following traumatic exposure at the site of the World Trade Center terrorist attacks. Despite relatively low levels of symptom reporting, workers endorsed an increase in both negative mood symptoms and functional impairment at the one-year anniversary of their traumatic exposure (compared to 6 months postexposure). For those individuals who met at least partial criteria for PTSD immediately following exposure, overall self-reported PTSD symptoms tended to increase from 6 to 12 months. This tendency resulted specifically from an increase in hyperarousal symptoms. Although few endorsed symptoms at clinical levels, our results demonstrate that disaster relief workers may experience an increase in symptomatology at the anniversary of their traumatic exposure. [source] | ||||||||||||||||||||||||||||||||||||||||||||||