JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2004
Aanand D. Naik MD
Objectives: To identify the specific bathing subtasks that are affected in community-living-older persons with bathing disability and to determine the self-reported reasons for bathing disability. Design: Cross-sectional study. Setting: General community of greater New Haven, Connecticut. Participants: A total of 626 community-living persons, aged 73 and older, who completed a comprehensive assessment, including a detailed evaluation of bathing disability. Measurements: Trained research nurses assessed bathing disability (defined as requiring personal assistance or having difficulty washing and drying the whole body), the specific bathing subtasks that were affected, and the main reasons (up to three) for bathing disability. Results: Disability in bathing was present in 195 (31%) participants; of these, 97 required personal assistance (i.e., dependence), and 98 had difficulty bathing. Participants with bathing disability reported a mean±standard deviation of 4.0±2.4 affected subtasks. The prevalence rate of disability for the eight prespecified bathing subtasks ranged from 25% for taking off clothes to 75% for leaving the bathing position. The majority of participants (59%) provided more than one reason for bathing disability. The most common reasons cited by participants for their bathing disability were balance problems (28%), arthritic complaints (26%), and fall or fear of falling (23%). Conclusion: For community-living older persons, disability in bathing is common, involves multiple subtasks, and is attributable to an array of physical and psychological problems. Preventive and restorative interventions for bathing disability will need to account for the inherent complexity of this essential activity of daily living. [source]

Prevalence and genotype distribution of hepatitis C virus among apparently healthy individuals in Mongolia: a population-based nationwide study

LIVER INTERNATIONAL, Issue 10 2008
Oidov Baatarkhuu
Abstract Background and Aims: Hepatitis C virus (HCV) is one of the major causes of liver cirrhosis and hepatocellular carcinoma (HCC) in Mongolia. However, there are no data concerning nationwide prevalence of HCV infection in Mongolia. We intended to investigate the population-based prevalence of HCV infection and genotype distribution among 1512 apparently healthy individuals in this country. Methods: Between April 2003 and December 2005, sera from 1512 residents of Ulaanbaatar and 12 provinces were collected by two-stage cluster random sampling, and anti-HCV was tested. Anti-HCV-positive samples were tested for HCV RNA by reverse transcription polymerase chain reaction, and HCV genotype was determined. Results: The mean age of the subjects was 46.2±17.8 years, and 812 (53.7%) were male. Overall, the prevalence of anti-HCV was 15.6% (236/1512) and HCV RNA was detected in 167 subjects (11.0%), with the most common genotype being 1b (165/167, 98.8%). When the HCV RNA-positive subjects were categorized by decade of age, the prevalence in each age group was as follows: 2.5% in subjects ,10 years of age, 4.5% in teens, 10.1% in 20's, 12.5% in 30's, 24.2% in 40's, 29.0% in 50's and 32.6% in subjects ,61 years of age. The seroprevalence of anti-HCV in a risk group, nurses, was not significantly different from the general population in each decade of age (P>0.05). Conclusions: Approximately 11.0% of apparently healthy population had detectable HCV RNA in Mongolia, and the predominant genotype of HCV was 1b. Preventive and therapeutic strategies for chronic hepatitis C are urgently warranted in this HCV-endemic area. [source]

The Breakdown of Preformed Advanced Glycation End Products Reverses Erectile Dysfunction in Streptozotocin-Induced Diabetic Rats: Preventive Versus Curative Treatment

THE JOURNAL OF SEXUAL MEDICINE, Issue 2 2006
Mustafa F. Usta MD
ABSTRACT Objectives., Accumulation of advanced glycation end products (AGEs) has been linked to many of the complications of diabetes mellitus, including erectile dysfunction (ED). Furthermore, it has been demonstrated that inhibitors of AGE formation, such as aminoguanidine, can prevent ED in diabetic animals. However, it is unknown whether late administration of a putative cross-link breaker, ALT-711, can reverse diabetic ED. We therefore compared ALT-711 and aminoguanidine in their ability to reverse ED in diabetic rats. Materials and Methods., Male Sprague,Dawley rats were randomly divided into four groups: (i) age-matched controls; (ii) streptozotocin (STZ)-induced diabetic rats (60 mg/kg; intraperitoneal injection); (iii) STZ diabetic rats treated with ALT-711 (3 mg/kg/day, intraperitoneal injection); and (iv) STZ diabetic rats treated with aminoguanidine (1 gm/L in drinking water) during the final 6 weeks of 12 weeks of induced diabetes. At the end of 12 weeks, erectile response to cavernous nerve stimulation (CNS) was determined. Neuronal nitric oxide synthase (nNOS) contents were measured in all penises, and AGE levels were determined both in penile tissues and in serum samples. Results., Erectile responses to CNS and penile nNOS protein content were significantly reduced, while AGE levels were elevated in the penises and serum of untreated diabetic animals. Treatment with ALT-711, but not with aminoguanidine, reversed ED and nNOS depletion and reduced serum and penile tissue AGE levels. Conclusions., These results suggest that cross-link breakers, such as ALT-711, are the optimal therapeutic approach, compared with treatment with inhibitors of AGE formation, in the reversal of diabetes-related ED. Usta MF, Kendirci M, Gur S, Foxwell NA, Bivalacqua TJ, Cellek S, and Hellstrom WJG. The breakdown of preformed advanced glycation end products reverses erectile dysfunction in streptozotocin-induced diabetic rats: Preventive versus curative treatment. J Sex Med 2006;3:242,252. [source]

Recent developments in retinopathy of prematurity

ACTA OPHTHALMOLOGICA, Issue 2009
B MORTEMOUSQUE
The retinopathy remains the principal severe ophthalmologic complication of neonates with a gestationalage of 32 weeks or less. It's a major cause of lifelong blindness beginning in infancy. As many other ocular pathologies, including diabetic retinopathy, and age-related macular degeneration, result in vision loss because of aberrant neoangiogenesis. A common feature of these conditions is the presenceof hypoxic areas and overexpression of the proangiogenic vascular endothelialgrowth factor (VEGF). Its prevantion can be made by a better management of the oxygenation of these children but also by a better knowledge of the other risk factors. The prevailing current treatment, laser ablation of the retina, is destructive and only partially effective. Preventive and less destructive therapies are much more desirable. So, Angiogenesis, or the formation of new retinal blood vessels is a key feature of many proliferative retinal diseases including diabetic retinopathy,retinal vein occlusions, and retinopathy of prematurity. [source]

What are adolescent antecedents to antisocial personality disorder?

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2002
Rolf Loeber PhD
Background This paper fills a gap because there are very few studies that prospectively predict antisocial personality disorder (APD) from psychopathology earlier in life in clinic-referred samples of young males. Method The paper addresses the continuity between conduct disorder (CD) and other forms of psychopathology during ages 13,17 and modified APD at ages 18 and 19 (modified to remove the DSM-IV requirement of pre-existing CD by age 15) in the Developmental Trends Study. Results The results show that 82,90% of APD cases met criteria for CD at least once during ages 13,17, and very few youths who met criteria for ODD during this period progressed to APD without intermediate CD. While CD is a strong predictor of modified APD, when other factors were accounted for in regression analyses, the best predictors were callous/unemotional behaviour, depression and marijuana use. ADHD during ages 13,17 was not significant in the final model. Males with CD during adolescence who progressed to APD tended to commit more violence, as evident from their court records. Conclusions Implications are discussed for the conceptualization of developmental models leading to APD, the strengthening of relevant symptoms of CD predictive of APD, and preventive and remedial interventions. Copyright © 2002 Whurr Publishers Ltd. [source]

Economic aspects of diabetic foot care in a multidisciplinary setting: a review

DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 5 2007
Giovanni A. Matricali
Abstract Background To evaluate the economic aspects of diabetic foot care in a multidisciplinary setting. Method A review of the English language literature, published from 1966 to November 2005. Results The results of available studies on the cost-of-illness of diabetic foot problems are difficult to compare. Nevertheless trends concerning excess of costs, protraction in time of costs, positive correlation to severity of ulcer and/or peripheral vascular disease, contribution of in-hospital stay and length of stay, and the patient's own contribution to total costs, are obvious. Only a few cost-effectiveness and cost-utility studies are available. Most use a Markov based model to predict outcome and show an acceptable result on long-term. Conclusions Diabetic foot problems are frequent and are associated with high costs. A multidisciplinary approach to diabetic foot problems has proved to be cost saving with regard to cost of treatment itself. Nevertheless, it remained unclear if these savings could offset the overall costs involved in implementing this kind of approach. The few studies that address this issue specifically all show an acceptable cost-effectiveness, but often the profit will be evident after some years only, because long-term costs are involved. Based on these data, policymakers should foresee sufficient reimbursement for preventive and early curative measures, and not only for ,salvage manoeuvres'. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Treatment of diabetic nephropathy in its early stages

DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2003
Giacomo Deferrari
Abstract Diabetic nephropathy is one of the most frequent causes of end-stage renal disease (ESRD), and, in recent years, the number of diabetic patients entering renal replacement therapy has dramatically increased. The magnitude of the problem has led to numerous efforts to identify preventive and therapeutic strategies. In normoalbuminuric patients, optimal glycemic control (HbA1c lower than 7.5%) plays a fundamental role in the primary prevention of ESRD [weighted mean relative risk reduction (RRR) ,37% for metabolic control versus trivial renoprotection for intensive anti-hypertensive therapy or ACE-inhibitors (ACE-I)]. In the microalbuminuric stage, strict glycemic control probably reduces the incidence of overt nephropathy (weighted mean RRR ,50%), while blood pressure levels below 130/80 mmHg are recommended according to the average blood pressure levels obtained in various studies. In normotensive patients, ACE-I markedly reduce the development of overt nephropathy almost regardless of blood pressure levels; in hypertensive patients, ACE-I are less clearly active (weighted mean RRR ,23% versus other drugs), whereas angiotensin-receptor blockers (ARB) appear strikingly renoprotective. Once overt proteinuria appears, it is uncertain whether glycemic control affects the progression of nephropathy. In type 1 diabetes, various anti-hypertensive treatments, mainly ACE-I, are effective in slowing down the progression of nephropathy; in type 2 diabetes, two recent studies demonstrate that ARB are superior to conventional therapy or calcium channel blockers (CCB). In clinical practice, pharmacological tools are not always used to the best benefit of the patients. Therefore, clinicians and patients need to be educated regarding the renoprotection of drugs inhibiting the renin-angiotensin system (RAS) and the overwhelming importance of achieving target blood pressure. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Mental health in Europe: problems, advances and challenges

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
W. Rutz
Objective:,To describe mental health care needs and challenges across the WHO European region of 51 nations. Method:,Based on morbidity and mortality data from HFA Statistical Database and Health21, the policy framework of WHO Europe, major trends in mental health care needs, psychiatric reform and mental health promotion are discussed. Results:,There is a mortality crisis related to mental ill health in Eastern European populations of transition. Destigmatization is required to improve early intervention and humanization of services, and national mental health audits are needed to create the basis for national mental health planning, implementation and monitoring. There are both problems and advances in service restructuring, and comprehensive mental health promotion programmes, preventive and monitoring strategies are required. Conclusion:,Partnerships between national and international organizations, especially WHO and the European Union, have to be strengthened to make progress on the way to integrated community mental health services. [source]

Using the ,protective environment' framework to analyse children's protection needs in Darfur

DISASTERS, Issue 4 2009
Alastair Ager
A major humanitarian concern during the continuing crisis in Darfur, Sudan, has been the protection of children, although there has been little in the way of comprehensive analysis to guide intervention. Founded on a situational analysis conducted between October 2005 and March 2006, this paper documents the significant threats to children's well-being directly linked to the political conflict. It demonstrates the role of non-conflict factors in exacerbating these dangers and in promoting additional protection violations, and it uses the ,protective environment' framework (UNICEF Sudan, 2006a) to identify systematic features of the current environment that put children at risk. This framework is shown to provide a coherent basis for assessment and planning, prompting broad, multidisciplinary analysis, concentrating on preventive and protective action, and fostering a systemic approach (rather than placing an undue focus on the discrete needs of ,vulnerable groups'). Constraints on its present utility in emergency settings are also noted. [source]

,-Amyloid immunization approaches for Alzheimer's disease

DRUG DEVELOPMENT RESEARCH, Issue 2 2002
Bruno P. Imbimbo
Abstract Alzheimer's disease (AD) represents the third leading cause of death in the U.S. and the leading cause of dementia in the elderly population. Until recently, there was little hope of efficiently combating this devastating disease. The deposition of ,-amyloid (A,) is the major pathological hallmark of AD brains. Genetic, biochemical, and pharmacological evidence support the hypothesis that A, plays a key role in the development of the disease. Thus, in the last 5 years a number of pharmacological strategies have been developed to interfere with the A, cascade. The most revolutionary of these approaches was proposed in 1999 by scientists at Elan Pharmaceuticals, which immunized against A, transgenic mice with spontaneously developing A, pathology. The immunization was achieved by subcutaneous injections of a preaggregated form of the synthetic human 42-amino acid A, emulsified with Freund's adjuvant, an immune stimulant. The vaccination caused a near complete inhibition of A, plaque formation in younger animals and a marked reduction of the A, burden in older animals. The effects on A, plaques were accompanied by a reduction of A,-associated astrogliosis and neuritic dystrophy. These results were later confirmed by other groups with similar vaccination protocols, which also demonstrated that the A, immunization of transgenic animals normalize or reduce the cognitive impairment associated with A, pathology. Interestingly, effective removal of brain A, plaques was also obtained by peripherally administering A, antibodies. The mechanism with which the vaccine increases A, clearance is not fully understood. Centrally, the vaccine appears to activate A, phagocytosis by microglial monocytes. Peripherally, serum A, antibodies bind and sequester A,, thus altering its equilibrium between CNS and plasma. The dramatic results obtained in animal models of AD raised unprecedented hopes for both a preventive and a curative intervention for this devastating disorder. A vaccine preparation for human use (AN-1792) composed of preaggregated human A,42 peptide and a highly purified saponin derivative (QS-21) was developed by Elan Pharmaceuticals and Wyeth Ayerst and tested in AD patients. Unfortunately, a Phase IIa study aimed at evaluating the safety and immunological activity of AN-1792 in 360 AD patients was discontinued because 15 subjects receiving the vaccine developed serious signs of CNS inflammation. Both central activation of cytotoxic T cells and autoimmune reactions were proposed as potential mechanisms of toxicity. Other therapeutic A, vaccination strategies are being pursued, including immuno-conjugates and monoclonal antibodies. The future of these and other A, immunization approaches depend on a clear understanding of the mechanism of A, clearance and additional insight into the role of inflammation in the AD brain. Drug Dev. Res. 56:150,162, 2002. © 2002 Wiley-Liss, Inc. [source]

Alcohol genetics: will the promise be fulfilled?

ADDICTION BIOLOGY, Issue 4 2000
Chris Cook
Genetic research into alcohol-related problems has a long history, but only with the recent advent of molecular biological techniques does it seem poised to fulfill its promise. While such research might be thought to reinforce views of the inevitability and immutability of drinking problems, there have been bold promises of important developments in our understanding of the aetiology of alcohol misuse, as well as promises of innovations in prevention and treatment. A brief consideration of recent research, and of the possibilities that are now before us, reveals that the promise of increased understanding of the aetiology of alcohol misuse is already being fulfilled. Promises of new preventive and therapeutic interventions, if they also are to be fulfilled, require that a number of practical and ethical issues be addressed. Clinicians, researchers and others in the addictions field need to begin to address the ethical issues that are raised. [source]

Enzymes in the acquired enamel pellicle

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2005
Christian Hannig
The acquired pellicle is a biofilm, free of bacteria, covering oral hard and soft tissues. It is composed of mucins, glycoproteins and proteins, among which are several enzymes. This review summarizes the present state of research on enzymes and their functions in the dental pellicle. Theoretically, all enzymes present in the oral cavity could be incorporated into the pellicle, but apparently enzymes are adsorbed selectively onto dental surfaces. There is clear evidence that enzymes are structural elements of the pellicle. Thereby they exhibit antibacterial properties but also facilitate bacterial colonization of dental hard tissues. Moreover, the immobilized enzymes are involved in modification and in homeostasis of the salivary pellicle. It has been demonstrated that amylase, lysozyme, carbonic anhydrases, glucosyltransferases and fructosyltransferase are immobilized in an active conformation in the pellicle layer formed in vivo. Other enzymes, such as peroxidase or transglutaminase, have been investigated in experimental pellicles. Despite the depicted impact of enzymes on the formation and function of pellicle, broader knowledge on their properties in the in vivo -formed pellicle is required. This might be beneficial in the development of new preventive and diagnostic strategies. [source]

The assessment of the impacts of the security management in a competitive environment

EUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 5 2009
Ettore Bompard
Abstract Security management is of the utmost importance in power system and many efforts have been made on this issue since a reliable supply of electricity is crucial to the modern societies. The traditional approach adopted in Europe is based on the "n,,,1" steady-state security that is efficient, although restrictive, and can continue to play an important role also in the new competitive context. In this paper, three alternative market-based models for security consideration are introduced, according to preventive and corrective control approaches. The models are presented and analyzed in terms of their economic impacts on the market throughout a set of useful indexes that allows for a ranking of the advantages got from the re-enforcement of the lines. Moreover, the positive impacts of the phase-shifter (PS) installation for the security and congestion management are quantified and indexes are derived to assess their optimal location. The different models and the exploitation of the proposed indexes are illustrated with reference to a 34-bus test system. Copyright © 2008 John Wiley & Sons, Ltd. [source]

On-line dynamic security assessment to mitigate the risk of blackout in the Italian power system

EUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 8 2008
Diego Cirio
Abstract This paper provides a comprehensive survey of the major initiatives and research projects recently carried out by the Italian system operator, Cesi Ricerca, and Universities on power system monitoring, defense, and security assessment. The technological and methodological features of an advanced wide area measurement system (WAMS) are described and the main aspects of an adaptive system for event-based automatic load shedding are presented. Then preventive and corrective security assessment, with particular emphasis to dynamic security assessment,DSA, is introduced. Results from an EU project, where the Italian power system served as a test site for on-line experimentation, are reported. Considering the need for very fast assessment by stability indices, a complementary approach to the above "conventional" DSA, currently under way, is described in further detail. The methodology relies on a correlation model relating significant power system measurements with local loadability margins. Results of some tests on the Italian power system are presented and discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Lessons learned from DNA repair defective syndromes

EXPERIMENTAL DERMATOLOGY, Issue 6 2007
Kai-Martin Thoms
Abstract:, Genomic instability is the driving force behind cancer development. Human syndromes with DNA repair deficiencies comprise unique opportunities to study the clinical consequences of faulty genome maintenance leading to premature aging and premature cancer development. These syndromes include chromosomal breakage syndromes with defects in DNA damage signal transduction and double-strand break repair, mismatch repair defective syndromes as well as nucleotide excision repair defective syndromes. The same genes that are severely affected in these model diseases may harbour more subtle variations in the ,healthy' normal population leading to genomic instability, cancer development, and accelerated aging at later stages of life. Thus, studying those syndromes and the molecular mechanisms behind can significantly contribute to our understanding of (skin) cancerogenesis as well as to the development of novel individualized preventive and therapeutic anticancer strategies. The establishment of centers of excellence for studying rare genetic model diseases may be helpful in this direction. [source]

Common Threat and Common Response?

GOVERNMENT AND OPPOSITION, Issue 3 2007
The European Union's Counter-Terrorism Strategy, its Problems
On the basis of an analysis of the European Union's common definition of the post-9/11 terrorist threat, this article provides a critical assessment of the EU's response. The EU has arrived at a reasonably specific definition of the common threat that avoids simplistic reductions and is a response that is sufficiently multidimensional to address the different aspects , internal and external, legislative and operational, repressive and preventive , of this threat. Yet the definition is undermined by differences between national threat perceptions. The preference for instruments of cooperation and coordination rather than integration, and poor implementation are having a negative impact on the effectiveness of the common response, the legitimacy of which is also weakened by limited parliamentary and judicial control. [source]

Diagnosis and Treatment of the Menstrual Migraine Patient

HEADACHE, Issue 2008
Stephen D. Silberstein MD
Women presenting with recurrent disabling headache frequently have migraine; but physicians need to rule out other headache disorders before they reach a diagnosis of migraine with or without aura. Many women who experience migraine in close association to their menstrual cycle may meet the diagnostic criteria for either menstrually related migraine (MRM), or pure menstrual migraine (PMM). Once an accurate diagnosis is made, treatment may be established to best suit the individual needs of that patient. Most women will find that migraine associated with hormone fluctuations respond well to standard treatment approaches including pharmacological and nonpharmacological treatments. Pharmacological approaches include acute, preventive, and short-term prophylaxis. Herein we review the difference between non-menstrual migraine, PMM, and MRM and identify effective treatment strategies for appropriate management of migraine associated with hormonal fluctuations. [source]

Rational Combination Therapy in Refractory Migraine

HEADACHE, Issue 6 2008
B. Lee Peterlin DO
Refractory migraine (RM) headaches pose important treatment challenges to the patients who live with them and the clinicians who try to treat them. Defined based on the lack of response to acute, preventive, and nonpharmacologic treatment, RM is often treated with a combination of treatments. Although combination therapy for RM has not been systematically studied in randomized trials, clinical experience suggests that a rational approach to RM treatment, utilizing a combination of treatments, may be effective where monotherapy has failed. In this article we briefly identify patient populations appropriate for more aggressive migraine prevention with combination therapy. We then discuss modifiable risk factors and comorbidities in migraine and then focus on the use of rational combination therapy, as well as the duration migraine preventatives should be considered for use. Future research is needed to evaluate the full potential of rational combination treatment as a strategy for treating and ultimately preventing RM. [source]

Sunlight ultraviolet irradiation and BRAF V600 mutagenesis in human melanoma,

HUMAN MUTATION, Issue 8 2008
Ahmad Besaratinia
Abstract The incidence of melanoma, the most lethal form of skin cancer, continues to increase in the Western world. In addition to genetic alterations in high- and low-susceptibility genes identified for melanoma, somatic mutations in BRAF gene occur frequently in human melanoma and are distinctively linked to sun exposure. Of significance is a single hotspot codon, i.e., BRAF V600, wherein up to 92% of all mutations arise. Recent work in our laboratory has demonstrated that solar ultraviolet (UV) irradiation triggers mutagenesis through induction of various DNA lesions, many of which capable of producing similar types of mutations, as those seen in BRAF V600 variants in human melanoma. In this review article, we have discussed application of "DNA damage-targeted mutagenicity" of solar UV-irradiation for determining the mechanistic involvement of sunlight UV in BRAF V600 mutagenesis in human melanoma. We envision that establishing "DNA-damage derived mutagenesis" in this exceptionally unique target gene may resolve the underlying mechanism(s) of melanoma-genesis, thus helping define preventive and therapeutic measures against this malignant disease. Hum Mutat 0, 1,9, 2008. © 2008, Wiley-Liss, Inc. [source]

Complications during root canal irrigation , literature review and case reports

INTERNATIONAL ENDODONTIC JOURNAL, Issue 3 2000
M. Hülsmann
Abstract Literature review and case reports The literature concerning the aetiology, symptomatology and therapy of complications during root canal irrigation is reviewed. Three cases of inadvertent injection of sodium hypochlorite and hydrogen peroxide beyond the root apex are presented. Clinical symptoms are discussed, as well as preventive and therapeutic considerations. [source]

Enhanced efficacy of DNA vaccination against Her-2/neu tumor antigen by genetic adjuvants

INTERNATIONAL JOURNAL OF CANCER, Issue 1 2004
Sun Young Chang
Abstract Certain types of malignant tumors overexpress Her-2/neu, a transmembrane glycoprotein of the class I receptor tyrosine kinase erbB family. To develop an effective Her-2/neu vaccine for selective immunotherapy of these malignancies, we prepared Her-2/neu DNA plasmid encoding the transmembrane and extracellular domain (pHM) and tested the ability of this construct to induce antitumor immunity in animal models. In addition, we investigated the effects of cytokine used as a genetic adjuvant. Modulation by factors that affect T-cell function or hematopoiesis, including interleukin-12, interleukin-15, interleukin-18, interleukin-23, Eta-1, Flt3L and GM-CSF, was studied in the forms of monocistronic and bicistronic plasmid. Our results demonstrated that vaccination of pHM could induce successful antitumor immunity against Her-2/neu-expressing murine tumor cells in BALB/c mice. We also showed that the antitumor activity of pHM was augmented by coadministration and coexpression of different cytokines. Despite the similar levels of gene expression, the antitumor effects of bicistronic plasmids coexpressing Her-2/neu antigen and cytokine were improved in comparison with coadministration of separate monocistronic plasmid. In particular, coexpression of interleukin-18 or GM-CSF with Her-2/neu increased antitumor activity in both preventive and therapeutic experiments. These findings can help in the decision concerning which of the various cytokine adjuvants should be used for the development of a Her-2/neu DNA vaccine. In addition, our results from a large panel of cytokine adjuvants in the various tumor models may provide an insight into the important immune components of antitumor immunity. © 2004 Wiley-Liss, Inc. [source]

Phage display particles expressing tumor-specific antigens induce preventive and therapeutic anti-tumor immunity in murine p815 model

INTERNATIONAL JOURNAL OF CANCER, Issue 5 2002
Yuzhang Wu
Abstract The efficacy of phage display particles expressing tumor antigen P1A35-43 in inducing protective and therapeutic anti-tumor immune responses were studied. A protective immune response against a lethal progressive P815 mastocytoma tumor cell challenge was established after subcutaneous injection of phage display particles. Furthermore, the vaccine suppressed growth of pre-existing tumors. Immunization with the hybrid phage particles elicited P1A35,43 specific CTL responses and a Th1-dominated immune response with phage particle-specific secretion of IFN-, but not IL-4. Our results indicate that phage display particles might be a useful vaccine form for tumor-associated antigen epitopes in tumor immunotherapy. © 2002 Wiley-Liss, Inc. [source]

Are men shortchanged on health?

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2010
Perspective on life expectancy, morbidity, mortality in men, women in the United States
Summary Background:, Significant gender disparities exist in life expectancy and major disease morbidity. There is an urgent need to understand the major issues related to men's health that contributes to these significant disparities. It is hypothesized that men have higher and earlier morbidities, in addition to behavioral factors that contribute to their lower life expectancy. Methods:, Data was collected from CDC: Health United States, 2007; American Heart Association, American Obesity Association, and American Cancer Society. Results:, Men have lower life expectancy than women in most countries around the world including United States. This gender disparity is consistent regardless of geography, race and ethnicity. More men die of 12 out of the 15 leading causes of death than women. In addition, men have higher morbidity and mortality in coronary heart disease (CHD), hypertension, diabetes, and cancer. Conclusions:, Men's lower life expectancy may be explained by biological and clinical factors such as the higher incidence of cardiovascular metabolic disease and cancer. In the context of public health, raising awareness of cardiovascular and metabolic health is needed to reduce the gender disparity. In addition, consideration of preventive and early detection/intervention programs may improve men's health. [source]

Orthodontic considerations for gingival health during pregnancy: a review

INTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 1 2010
PM Mukherjee
Abstract:, Gingivitis is caused by several known systemic and local factors. Among systemic factors, the role of hormonal changes during pregnancy is well established. While presence of fixed orthodontic appliances alone may not cause gingivitis, factors such as pregnancy and poor oral hygiene combined together could precipitate acute gingival inflammation that may progress to a periodontal condition in a patient receiving orthodontic therapy. There has been an increase in the number of adult patients who are receiving orthodontic treatment. Orthodontic appliances could act as a potential plaque retentive source and aggravate inflammatory reactions that are seen during pregnancy. There is a lack of awareness regarding oral healthcare issues among patients who are pregnant and choose to seek orthodontic treatment. In addition, there is a need in the literature to outline management guidelines for patients who want to receive orthodontic treatment during pregnancy, with or without pre-existing gingival conditions. This review focuses on the aetiology of pregnancy gingivitis and the management of orthodontic patients during pregnancy. Our emphasis is on patient education, oral hygiene maintenance, preventive and treatment strategies for the management of gingival health in orthodontic patients during pregnancy. We also highlight some of the possible complications of initiating orthodontic treatment during pregnancy. [source]

Opportunities for an improved role for nurses in psychoactive substance use: Review of the literature

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2004
Annette M Nkowane RN RM BSc MA
Nurses form a core component of many health care systems so their role in responding to problems related to psychoactive substance use is crucial. They are often under-utilized, mainly because of anxieties concerning role adequacy, legitimacy, lack of support and failure to implement interventions in a variety of settings. Nurses have unique opportunities through interactions they have with young people, families and significant others. Training and career preparation should encompass development of innovative strategies, taking a leading role in management of substance use patients, involvement in the treatment of the homeless mentally ill, HIV-infected individuals and persons with dual disorders of mental health and substance use. Future directions should focus on developing skills for critical thinking, preventive and therapeutic interventions, clinical judgement, effective organizational capacity and team work. Barriers such as scope of practice, authority, ethical and legal issues surrounding health care for substance use need to be addressed. [source]

International Relations Theory and the Second Korean War

INTERNATIONAL STUDIES QUARTERLY, Issue 3 2003
David C. Kang
Ever since the first Korean war in 1950, scholars and policymakers have been predicting a second one, started by an invasion from the North. Whether seen as arising from preventive, preemptive, desperation, or simple aggressive motivations, the predominant perspective in the west sees North Korea as likely to instigate conflict. Yet for fifty years North Korea has not come close to starting a war. Why were so many scholars so consistently wrong about North Korea's intentions? Social scientists can learn as much from events that did not happen as from those that did. The case of North Korea provides a window with which to examine these theories of conflict initiation, and reveals how the assumptions underlying these theories can become mis-specified. Either scholars misunderstood the initial conditions, or they misunderstood the theory, and I show that scholars have made mistakes in both areas. Social science moves forward from clear statement of a theory, its causal logic, and its predictions. However, just as important is the rigorous assessment of a theory, especially if the predictions fail to materialize. North Korea never had the material capabilities to be a serious contender to the U.S.,ROK alliance, and it quickly fell further behind. The real question has not been whether North Korea would preempt as South Korea caught up, but instead why North Korea might fight as it fell further and further behind. The explanation for a half-century of stability and peace on the Korean peninsula is actually quite simple: deterrence works. [source]

The Poor Outcome of Ischemic Stroke in Very Old People: A Cohort Study of Its Determinants

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2010
Licia Denti MD
OBJECTIVES: To assess how much of the excess risk of poor outcome from stroke in people aged 80 and older aging per se explains, independent of other prognostic determinants. DESIGN: Cohort, observational. SETTING: University hospital. PARTICIPANTS: One thousand five hundred fifty-five patients with first-ever ischemic stroke consecutively referred to an in-hospital Clinical Pathway program were studied. MEASUREMENTS: The relationship between age and 1-month outcome (death, disability (modified Rankin Scale 3,5), and poor outcome (modified Rankin Scale 3,6)) was assessed, with adjustment for several prognostic factors. RESULTS: Six hundred twelve patients aged 80 and older showed worse outcome after 1 month than those who were younger, in terms of mortality (19% vs 5%, hazard ratio (HR)=3.85, 95% confidence interval (CI)=2.8,5.4) and disability (51% vs 33%, odds ratio (OR)=3.16, 95% CI=2.5,4.0), although in multivariate models, the adjusted HR for mortality decreased to 1.47 (95% CI=1.0,2.16) and the ORs for disability and poor outcome decreased to 1.76 (95% CI=1.32,2.3.) and 1.83 (95% CI=137,2.43), respectively. Stroke severity, the occurrence of at least one medical complication, and premorbid disability explained most of the risk excess in the oldest-old. CONCLUSION: Stroke outcome is definitely worse in very old people, and most of the excess risk of death and disability is attributable to the higher occurrences of the most-severe clinical stroke syndromes and of medical complications in the acute phase. These represent potential targets for preventive and therapeutical strategies specifically for elderly people. [source]

Patterns of Utilization for the Minnesota Senior Health Options Program

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2004
Robert L. Kane MD
Objectives: To compare the use of medical services provided under the Minnesota Senior Health Options (MSHO) (a special program designed to serve dually eligible older persons) with that provided to controls who received fee-for-service Medicare and Medicaid managed care. Design: Quasi-experimental design using two control groups; separate matched cohort and rolling cross-sectional analyses; regression models used to adjust for case-mix differences. Setting: Urban Minnesota community and nursing home long-term care. Participants: Dually eligible elderly MSHO enrollees in the community and in nursing homes were compared with two sets of controls; one was drawn from nonenrollees living in the same area (control-in) and another from comparable persons living in another urban area where the program was not available (control-out). Cohorts living in the community and in nursing homes were included. Measurements: Use of hospitals and emergency rooms, physician visits. Results: In the community cohort, there were no significant differences in hospital admission rates or in hospital days. MSHO enrollees had significantly fewer preventable hospital admissions and significantly fewer preventable emergency services than the control-in group. MSHO nursing home enrollees had significantly fewer hospital admissions than either control group with or without adjustment at 12 and 18 months. MSHO enrollees had significantly fewer hospital days and preventable hospitalizations than the control-in group. MSHO enrollees had significantly fewer emergency room visits and preventable emergency room visits than either control group. Conclusion: In general, the results of this evaluation are mixed but favor MSHO. The effect of MSHO was stronger for nursing home enrollees than community enrollees. The lower rate of preventable hospitalizations and emergency room visits of MSHO enrollees suggests that MSHO affected the process of care by providing more of some types of preventive and community-care services for community residents. [source]

Mixed Dementia: Epidemiology, Diagnosis, and Treatment

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2002
Dina Zekry MD
Alzheimer's disease (AD) and vascular dementia (VaD) are the most frequent causes of dementia in older people. Although AD can be diagnosed with a considerable degree of accuracy, the distinction between isolated AD, VaD, and mixed dementia (MD), where both pathologies coexist in the same patient, remains a controversial issue and one of the most difficult diagnostic challenges. Although MD represents a very frequent pathology, especially in older people, as reported in neuropathological studies, the respective importance of degenerative and vascular lesions, their interaction in the genesis of dementia, and the mere existence of MD are still debated. Accurate diagnosis of MD is of crucial significance for epidemiological purposes and for preventive and therapeutic strategies. Until recently, pharmacological studies have generally focused on pure disease, AD or VaD, and have provided little information on the best therapeutic approach to MD. This article provides an overview of MD in older people. A retrospective review of the recent literature on prevalence, incidence, course, risk factors, diagnosis, and treatment of MD was performed. The article also emphasizes the need for further studies, including neuropsychological and functional evaluations, and neuroimaging and clinicopathological correlations to develop a better understanding of MD, which appears to be one of the most common forms of dementia. [source]

smcL as a novel diagnostic marker for quantitative detection of Listeria ivanovii in biological samples

JOURNAL OF APPLIED MICROBIOLOGY, Issue 3 2010
D. Rodríguez-Lázaro
Abstract Aims:, To develop a novel molecular tool for the quantitative detection of the ruminant pathogen Listeria ivanovii in different biological matrices. Methods and Results:, A real-time PCR (RTi-PCR) for the quantitative and species-specific identification of L. ivanovii was designed to target the region of the smcL gene. The assay includes an internal amplification control (IAC) to avoid false-negative results. The smcL -IAC RTi-PCR assay was 100% selective and allowed the detection of as little as one genome equivalent in 45% of reactions. The quantification accuracy was excellent, as demonstrated by its high linearity (R2 > 0·9989) and PCR efficiency (E > 0·984) over a 6-log dynamic range, down to 10 genome equivalents. Finally, the applicability of this assay was evaluated with artificially contaminated biological matrices implicated in the transmission of this bacterium such as sheep raw milk, blood and amniotic fluid. The smcL -IAC RTi-PCR assay allowed the detection of as few as 50 colony forming unit numbers (CFUs) per 25 ml of raw milk, 43 CFUs per 1 ml of blood or 50 CFUs per 1 ml of amniotic fluid. Conclusions:, This method can be an adequate alternative for the identification of L. ivanovii and for complete diagnosis of animal and human listeriosis. Significance and Impact of the Study:, We present an alternative for the detection of another pathogenic member of Listeria genus, which can help to distinguish from Listeria monocytogenes and therefore facilitates the establishment of preventive and prophylactic measures in food and farm environments. [source]