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Terms modified by Serious Selected Abstracts,A Serious and Dangerous Matter': Transgression and the Death of GodCRITICAL QUARTERLY, Issue 2008Article first published online: 10 APR 200 First page of article [source] Patients Presenting to the Emergency Department With Non-specific Complaints: The Basel Non-specific Complaints (BANC) StudyACADEMIC EMERGENCY MEDICINE, Issue 3 2010Marek Nemec MD Abstract Objectives:, Patient management in emergency departments (EDs) is often based on management protocols developed for specific complaints like dyspnea, chest pain, or syncope. To the best of our knowledge, to date no protocols exist for patients with nonspecific complaints (NSCs) such as "weakness,""dizziness," or "feeling unwell." The objectives of this study were to provide a framework for research and a description of patients with NSCs presenting to EDs. Methods:, Nonspecific complaints were defined as the entity of complaints not part of the set of specific complaints for which evidence-based management protocols for emergency physicians (EPs) exist. "Serious conditions" were defined as potentially life-threatening or those requiring early intervention to prevent health status deterioration. During a 6-month period, all adult nontrauma patients with an Emergency Severity Index (ESI) of 2 or 3 were prospectively enrolled, and serious conditions were identified within a 30-day period. Results:, The authors screened 18,261 patients for inclusion. A total of 218 of 1,611 (13.5%) nontrauma ESI 2 and 3 patients presented with NSCs. Median age was 82 years (interquartile range [IQR] = 72 to 87), and 24 of 218 (11%) were nursing home inhabitants. A median of 4 (IQR = 3 to 5) comorbidities were recorded, most often chronic hypertension, coronary artery disease, and dementia. During the 30-day follow-up period a serious condition was diagnosed in 128 of 218 patients (59%). The 30-day mortality rate was 6%. Conclusions:, Patients with NSC presenting to the ED are at high risk of suffering from serious conditions. Sensitive risk stratification tools are needed to identify patients with potentially adverse health outcomes. ACADEMIC EMERGENCY MEDICINE 2010; 17:284,292 © 2010 by the Society for Academic Emergency Medicine [source] Behavioral treatment of substance abuse in schizophreniaJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2009Wendy N. Tenhula Abstract Co-occurring substance use disorders are highly prevalent among individuals with schizophrenia and other serious and persistent mental illnesses (SPMI) and are associated with clinically significant consequences. A multifaceted behavioral treatment called Behavioral Treatment for Substance Abuse in Serious and Persistent Mental Illness (BTSAS) can reduce substance abuse in persons with SPMI. The key treatment strategies in BTSAS include a urinalysis contingency, short-term goal setting, training in drug refusal skills, psychoeducation about the impact of drug use, and relapse prevention training. A case example illustrating the application of BTSAS is presented and relevant clinical issues are discussed. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1,11, 2009. [source] Why Women Need to Get Serious About Heart Health NowNURSING FOR WOMENS HEALTH, Issue 5 2006Patricia L. Dougherty CNM First page of article [source] Randomized controlled trial of intraputamenal glial cell line,derived neurotrophic factor infusion in Parkinson diseaseANNALS OF NEUROLOGY, Issue 3 2006Anthony E. Lang MD Objective Glial cell line,derived neurotrophic factor (GDNF) exerts potent trophic influence on midbrain dopaminergic neurons. This randomized controlled clinical trial was designed to confirm initial clinical benefits observed in a small, open-label trial using intraputamenal (Ipu) infusion of recombinant human GDNF (liatermin). Methods Thirty-four PD patients were randomized 1 to 1 to receive bilateral continuous Ipu infusion of liatermin 15,g/putamen/day or placebo. The primary end point was the change in Unified Parkinson Disease Rating Scale (UPDRS) motor score in the practically defined off condition at 6 months. Secondary end points included other UPDRS scores, motor tests, dyskinesia ratings, patient diaries, and 18F-dopa uptake. Results At 6 months, mean percentage changes in "off" UPDRS motor score were ,10.0% and ,4.5% in the liatermin and placebo groups, respectively. This treatment difference was not significant (95% confidence interval, ,23.0 to 12.0, p = 0.53). Secondary end point results were similar between the groups. A 32.5% treatment difference favoring liatermin in mean 18F-dopa influx constant (p = 0.019) was observed. Serious, device-related adverse events required surgical repositioning of catheters in two patients and removal of devices in another. Neutralizing antiliatermin antibodies were detected in three patients (one on-study and two in the open-label extension). Interpretation Liatermin did not confer the predetermined level of clinical benefit to patients with PD despite increased 18F-dopa uptake. It is uncertain whether technical differences between this trial and positive open-label studies contributed in any way this negative outcome. Ann Neurol 2006 [source] Evaluating the accuracy of Malformations Surveillance Program in detecting virilization due to congenital adrenal hyperplasiaCONGENITAL ANOMALIES, Issue 1 2005Julie Travitz ABSTRACT Malformations surveillance programs of newborn infants have been developed as a method for identifying serious and relatively common birth defects. The virilization of newborn infants with the classic 21-hydroxylase form of congenital adrenal hyperplasia must be identified early if the associated metabolic crisis in the perinatal period is to be prevented. We compared the detection of virilization associated with 21-hydroxylase congenital adrenal hyperplasia in infants by three methods: an ,active' malformations surveillance of medical records at a large urban hospital; routine medical care by examining physicians; and newborn biochemical screening of blood samples. The experience at a large maternity center in Boston, since 1972, showed that pediatricians often recognized affected females (6/6), but not males (0/2); the state newborn screening program, begun in 1990, identified correctly all affected males and females. The Active Malformations Surveillance Program was the least effective screening method, identifying four of six affected females and neither of the affected males. The low rate of detecting affected females by the Surveillance Program was attributed to a failure to sensitize the research assistants to the importance of physicians' notations regarding the signs and symptoms of virilization. The failure of examining physicians, and thereby, the malformations surveillance program, to detect virilized newborn males was due to the lack of consistent associated physical features. These comparisons between these three methods of detection can be used to design and improve malformations surveillance programs. [source] Female Gender and the Risk of Rupture of Congenital Aneurysmal Fistula in AdultsCONGENITAL HEART DISEASE, Issue 1 2008Salah A.M. Said MD ABSTRACT Aims., To delineate the risk factors for rupture of congenital aneurysmal fistulas in adult patients. Methods., We conducted a literature search of the Medline database using Pubmed search interface to identify reports dealing with rupture of congenital aneurysmal fistulas in an adult population. The search included the English and non-English languages between 1963 and 2005. Results., Fourteen adult patients (12 females) with serious and life-threatening complications secondary to aneurysmal fistulas were reported. Mean age was 62.9 years. The ethnic origins of these 14 patients were 9 Asian and 5 Caucasian. Most patients have had no other cardiac malformations. Five patients had a history of hypertension. One patient was asymptomatic. In 13 symptomatic patients, the clinical presentation was cardiac tamponade, pericardial effusion, syncope, heart failure, chest pain, dyspnea, fatigue, distal thromboembolic events with infarction, shock, and/or sudden death. Aneurysmal fistulas were identified in 10 patients; of these 6 were of the saccular type. Rupture occurred in 9 patients (8 females and 1 male). Eleven patients were treated surgically with 1 late death. Two male subjects experienced sudden unexpected cardiac death. Conclusion., Rupture of congenital aneurysmal fistulas occurred more often in females. Identified risk factors for rupture, hemopericardium, tamponade, and death were among others saccular aneurysm, Asian ethnic race, origin of the aneurysmal fistulas from the left coronary artery and a history of hypertension may play a role. In this article, we present a literature review of congenital aneurysmal fistulas associated with or without rupture and a case report of a woman with unruptured aneurysmal fistula. [source] Habitat Loss and Extinction in the Hotspots of BiodiversityCONSERVATION BIOLOGY, Issue 4 2002Thomas M. Brooks None of these hotspots have more than one-third of their pristine habitat remaining. Historically, they covered 12% of the land's surface, but today their intact habitat covers only 1.4% of the land. As a result of this habitat loss, we expect many of the hotspot endemics to have either become extinct or,because much of the habitat loss is recent,to be threatened with extinction. We used World Conservation Union [ IUCN ] Red Lists to test this expectation. Overall, between one-half and two-thirds of all threatened plants and 57% of all threatened terrestrial vertebrates are hotspot endemics. For birds and mammals, in general, predictions of extinction in the hotspots based on habitat loss match numbers of species independently judged extinct or threatened. In two classes of hotspots the match is not as close. On oceanic islands, habitat loss underestimates extinction because introduced species have driven extinctions beyond those caused by habitat loss on these islands. In large hotspots, conversely, habitat loss overestimates extinction, suggesting scale dependence (this effect is also apparent for plants). For reptiles, amphibians, and plants, many fewer hotspot endemics are considered threatened or extinct than we would expect based on habitat loss. This mismatch is small in temperate hotspots, however, suggesting that many threatened endemic species in the poorly known tropical hotspots have yet to be included on the IUCN Red Lists. We then asked in which hotspots the consequences of further habitat loss (either absolute or given current rates of deforestation) would be most serious. Our results suggest that the Eastern Arc and Coastal Forests of Tanzania-Kenya, Philippines, and Polynesia-Micronesia can least afford to lose more habitat and that, if current deforestation rates continue, the Caribbean, Tropical Andes, Philippines, Mesoamerica, Sundaland, Indo-Burma, Madagascar, and Chocó,Darién,Western Ecuador will lose the most species in the near future. Without urgent conservation intervention, we face mass extinctions in the hotspots. Resumen: Casi la mitad del total de plantas vasculares del mundo y un tercio de los vertebrados terrestres son endémicos en 25 "áreas críticas" para la biodiversidad, cada una de las cuales tiene por lo menos 1500 especies de plantas endémicas. En ninguno de estos sitios permanece más de un tercio de su hábitat prístino. Históricamente, cubrían 12% de la superficie terrestre, pero en la actualidad su hábitat intacto cubre solo 1.4% del terreno. Como resultado de esta pérdida de hábitat esperamos que muchas de las especies endémicas a estos sitios estén extintas o , porque la pérdida de hábitat es reciente , se encuentren amenazadas de extinción. Utilizamos Listas Rojas de UICN para comprobar esta predicción. En general, entre la mitad y dos tercios de las plantas amenazadas y el 57% de los vertebrados terrestres amenazados son endémicos de áreas críticas para la biodiversidad. Para aves y mamíferos en general, las predicciones de extinción en las áreas críticas para la biodiversidad, basadas en la pérdida de hábitat, coinciden con el número de especies consideradas extintas o amenazadas independientemente. En dos clases de áreas críticas para la biodiversidad la coincidencia no es muy grande. En islas oceánicas, la pérdida de hábitat subestima la extinción porque las especies introducidas han causado más extinciones que las producidas por la reducción del hábitat. Por lo contrario, la pérdida de hábitat sobrestima la extinción en áreas críticas para la biodiversidad extensas, lo que sugiere una dependencia de escala (este efecto también es aparente para plantas). Para reptiles, anfibios y plantas mucho menos especies endémicas son consideradas amenazadas o extintas por pérdida de hábitat. Sin embargo, esta discordancia es pequeña en áreas críticas para la biodiversidad en zonas templadas templadas, lo que sugiere que muchas especies endémicas amenazadas en las poco conocidas áreas críticas para la biodiversidad en zonas tropicales aun están por incluirse en las Listas Rojas. Posteriormente nos preguntamos en que áreas críticas para la biodiversidad serían más serias las consecuencias de una mayor pérdida de hábitat (absoluta o con las tasas actuales de deforestación). Nuestros resultados sugieren que el Arco Oriental y los Bosques Costeros de Tanzania/Kenia, Filipinas, Polinesia/Micronesia no pueden soportar mayores pérdidas y que, si continúan las tasas de deforestación actuales, el Caribe, Andes Tropicales, Filipinas, Mesoamérica, Sundaland, Indo-Burma, Madagascar y Chocó/Darién/Ecuador Occidental perderán más especies en el futuro. Sin acciones urgentes de conservación, habrá extinciones masivas en las áreas críticas para la biodiversidad. [source] The Agency Problems, Firm Performance and Monitoring Mechanisms: the evidence from collateralised shares in TaiwanCORPORATE GOVERNANCE, Issue 3 2004Lanfeng Kao This paper indicates that there is an inverse relationship between collateralised shares and firm performance. We further show that this inverse relationship exists only in conglomerate firms. These findings imply that agency problems resulting from shares used as collateral by boards of directors are more serious in conglomerate firms than in non-conglomerate firms. Moreover, we provide evidence that monitoring by institutional investors, creditors and dividend policy can effectively reduce the agency problems of shares used as collateral and thus can improve firm performance. [source] Psychopathy and offence severity in sexually aggressive and violent youthCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2009Amber Fougere Background,A large proportion of violent crimes are committed by youths. Youths with psychopathic traits may have a higher risk for recidivism and violence. Aims/hypotheses,Our aim was to compare sexually aggressive with violent young men on offence severity and psychopathy. Three hypotheses were proposed: first, young men with previous offences would display a progressive increase in seriousness of offence during their criminal career; secondly, the sexually aggressive and violent young men would not differ in scores on the Hare Psychopathy Checklist: Youth Version (PCL:YV); but, thirdly, PCL:YV scores would be positively correlated with the severity of the index crime, as measured by the Cormier,Lang System for Quantifying Criminal History. Methods,Information was collected from the files of 40 young men in conflict with the law, and the PCL:Youth Version (YV) rated from this by trained raters. Results,The offences of these young men became more serious over time, but we found no association between PCL:YV scores and offence type or seriousness. Conclusions and implications,This exploratory research suggests the importance of understanding the progression in offending careers, but a limited role for the PCL:YV in doing so. Given the small sample size, however, and the limit on access to information about details of age, the findings need replication. Copyright © 2009 John Wiley & Sons, Ltd. [source] Does PTSD occur in sentenced prison populations?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2007A systematic literature review Background,A systematic review of the literature on mental disorder in prisoners, published in 2002, made no mention of post-traumatic stress disorder (PTSD), but indicators from other studies suggest that a history of serious and chronic trauma is common among offenders. Aims,To conduct a systematic review of the literature with the specific questions: does any epidemiological study of sentenced prisoners include data on prevalence of PTSD while in prison? If so, what is the prevalence in this group? Method,Literature databases EMBASE, Medline, PsychInfo, PILOTS and SIGLE were searched. The Journal of Traumatic Stress was searched manually. Preliminary screening was conducted by reading abstracts of hundreds of papers. Ten exclusion criteria were then applied to the screened selection. Reference sections of all accessed papers were searched for any further studies. Results,One hundred and three potentially relevant papers were identified after preliminary screening. Four met all criteria for inclusion and suffered none of the exclusion criteria. PTSD rates ranged from 4% of the sample to 21%. Women were disproportionately affected. Conclusions and implications for practice,All four papers suggested that the prevalence of PTSD among sentenced prisoners is higher than that in the general population, as reported elsewhere. Overall the findings suggest a likely need for PTSD treatment services for sentenced prisoners. Copyright © 2007 John Wiley & Sons, Ltd. [source] Guidelines for the management of traumatic dental injuries.DENTAL TRAUMATOLOGY, Issue 3 2007Abstract,,, Avulsion of permanent teeth is the most serious of all dental injuries. The prognosis depends on the measures taken at the place of accident or the time immediately after the avulsion. Replantation is the treatment of choice, but cannot always be carried out immediately. An appropriate emergency management and treatment plan is important for a good prognosis. Guidelines are useful for delivering the best care possible in an efficient manner. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases in which the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the current best evidence based on literature research and professional opinion. In this second article of three, the IADT Guidelines for management of avulsed permanent teeth are presented. [source] A retrospective study of traumatic dental injuries in a Brazilian dental trauma clinicDENTAL TRAUMATOLOGY, Issue 6 2001Arnaldo De França Caldas Jr Abstract , The purpose of this retrospective study was to analyse data from the records of patients seen in the dental trauma emergency clinic in a general hospital in the city of Recife, Brazil, during the years 1997,1999, according to sex, age, cause, number of injured teeth, type of tooth and type of trauma. The records of all patients seen by dentists were collected. Altogether, 250 patients from 1 to 59 years of age presenting 403 dental injuries were examined and/or treated. The causes of dento-alveolar trauma were classified in five categories: home injuries, street injuries, school injuries, sports activities, violence. The type of trauma was classified by dentists working at the dental trauma clinic on the basis of Andreasen's classification. The gender difference in the number of cases of trauma was statistically significant (males 63.2% vs females 36.8) (P<0.0001). Fracture in enamel only (51.6%) and fractures in dentine (40.8%) were the most commonly occurring types of injury. Injuries were most frequently diagnosed as serious among the youngest patients (up to 15 years of age); 82.4% of intrusive luxation cases were diagnosed in the 1,5 years age group. The main causes of tooth injury were falls (72.4%), collisions with objects (9.2%), violence (8.0%), traffic accidents (6.8%) and sports (3.6%). Trauma caused by violence was found to be statistically significant in the 6,15 years age group (P<0.0005). [source] Persistence and Improvement of Nasolabial Fold Correction with Nonanimal-Stabilized Hyaluronic Acid 100,000 Gel Particles/mL Filler on Two Retreatment Schedules: Results up to 18 Months on Two Retreatment SchedulesDERMATOLOGIC SURGERY, Issue 2008RHODA S. NARINS MD BACKGROUND Nonanimal-stabilized hyaluronic acid (NASHA) fillers are frequently used for facial soft tissue augmentation. Their long-term efficacy and the effects of different retreatment schedules are not well established. OBJECTIVE This is an 18-month interim analysis of a 30-month study to evaluate the efficacy and persistence of NASHA 100,000 gel particles/mL filler with two different retreatment schedules. METHODS This multicenter, randomized, evaluator-blinded study enrolled 75 patients with moderate to severe nasolabial folds. Patients were randomized to retreatment of one nasolabial fold at 4.5 months and the contralateral fold at 9 months after correction of both folds at the initial visit. RESULTS Wrinkle Severity Rating Scale scores improved significantly (p<.001) from baseline, with mean improvements ranging from 1.1 to 1.7 grades. Almost all patients (97%) responded satisfactorily, and the efficacy of the retreatment schedules did not differ significantly. Adverse events, primarily swelling and bruising, occurred in 33% of patients; none were serious. CONCLUSION The improvements seen after initial treatment with NASHA 100,000 gel particles/mL filler persisted for up to 18 months with one retreatment. The response was equivalent for retreatment at 4.5 and 9 months. [source] Therapeutic Hotline: Re-induction may be useful to manage psoriasis relapse during long-term maintenance treatment with infliximab: a retrospective analysisDERMATOLOGIC THERAPY, Issue 2 2010Gino Vena ABSTRACT Infliximab is an anti-tumor necrosis factor-alpha monoclonal antibody that is highly effective for the treatment of psoriatic disease. During maintenance treatment, some patients may experience a disease relapse, and, in such circumstances, dose intensification is frequently used to regain efficacy. We report our cumulative experience on the use of infliximab re-induction in patients whose psoriasis relapsed during long-term maintenance treatment with infliximab. From September 2005 to January 2009, 22 patients required re-induction because of a relapse of their psoriasis. Re-induction was effective in restoring response in most patients and was well tolerated in all cases, without occurrence of serious or unexpected adverse events. [source] Cnidarians and human skinDERMATOLOGIC THERAPY, Issue 1 2002William A. Burke Cnidarians are aquatic animals including the jellyfish, the Portuguese man-of-war, fire coral, hydroids, sea anemones, and coral. Many of these can harm human skin and rarely some envenomations can lead to a serious or even fatal outcome. This article discusses the varied creatures in this group that can harm man and potentially lead to serious envenomation syndromes. Treatment of cnidarian injuries and stings is discussed. [source] Cosmetics and contact dermatitisDERMATOLOGIC THERAPY, Issue 3 2001Ronni Wolf Modern cosmetic and skin care products are safe for most users and adverse reactions to them are very rare considering the number of people in contact with numerous products over a lifetime of use. Improvements in safety, tolerance, and skin compatibility will not prevent cosmetic product side effects from increasing in the future because of the continuing goals of intensifying their biological activity and therapeutic efficacy. Therefore, now more than ever, dermatologists should be familiar with all possible untoward reactions to cosmetics. Adverse reactions include an extreme variant of sensitive skin, called "cosmetic intolerance syndrome," describing individuals who are no longer able to tolerate a wide range of cosmetic products. "True" allergic reactions to cosmetics occur much less commonly than irritant reactions. These are of great importance to the dermatologist because they are more serious, more difficult to treat, and require absolute abstention from the causative agent. Eczematous, damaged skin is especially prone to develop allergies. [source] Arterial dissection complicating tonsillectomyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 9 2003E Wraige MRCPCH Tonsillectomy is a frequently performed surgical procedure. Surgical complications can be serious. We report the case of a 7,year-old female who experienced an arterial ischaemic cerebral infarction following elective adenotonsillectomy. [source] Prognostic impact of psychoactive substances use during hospitalization for intentional drug overdoseACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2005M. Tournier Objective:, To assess whether current use of psychoactive substance(s) is a prognostic factor during hospitalization for intentional drug overdose (IDO). Method:, Current intoxication with psychoactive substance(s) [cannabis, opiate, buprenorphine, amphetamine/ecstasy, cocaine, lysergic acid diethylamide (LSD)] was identified using toxicological urinalysis in 671 patients with IDO. An IDO was a priori defined as serious if associated with one of the following events: death, hospitalization in intensive care unit longer than 48 h, respiratory support, use of vasopressive drugs, cardiac massage or dialysis. Results:, Subjects positive for toxicological assays were twice as likely to present with serious IDO (OR = 1.9, 95% CI: 1.3,2.8, P = 0.001), independently from a large range of confounding factors. The risk of serious IDO was especially marked in subjects using LSD, buprenorphine or opiates. Conclusion:, Systematic investigation of substance use could be important to adapt medical management of subjects with IDO in general hospital, but also in primary care and psychiatric settings. [source] Living with Type 2 diabetes: a family perspectiveDIABETIC MEDICINE, Issue 7 2007P. White Abstract Aim To explore the beliefs, attitudes and perceptions of adults with Type 2 diabetes and their family members. Methods Focus groups were conducted with: (i) people with good diabetes control (HbA1c < 7.0%); (ii) their family members; (iii) people with poor diabetes control (HbA1c > 8.5%); and (iv) their family members. Results There were no discernible differences between those with good and poor diabetes control or between the family members of each group. Overall, family members perceived diabetes to be more serious and as having a greater impact on daily life than those with the illness. Those with diabetes were unaware of this heightened concern and had a more relaxed approach to living with diabetes. The lack of information and perceived knowledge about diabetes impacted upon participants' causal attributions about the illness and its perceived severity. Conclusions Diabetes is an illness that affects both individuals and families. There is a need for further investigation into the impact that family members have on the management of diabetes. [source] What role do extracellular matrix changes contribute to the cardiovascular disease burden of diabetes mellitus?DIABETIC MEDICINE, Issue 12 2005M. H. Tayebjee Abstract Matrix metalloproteinases (MMP) and their inhibitors (TIMP) are central factors in the control of extracellular matrix turnover. They are important in normal physiology and also during a range of pathological states. In this review, we have systematically identified clinical articles relevant to cardiovascular disease in diabetes from the last 10 years. Our aim was to outline the structure, function and regulation of metalloproteinases and their key roles in cardiomyopathy and vasculopathy in diabetes. We also explore the effects of drug intervention on both human subjects with diabetes and experimental animal models. The modulation of MMP and TIMP activity using drugs that affect the expression and function of these proteins may provide us with new ways to treat this serious and disabling disease, and we explore potential mechanisms and treatments. [source] BAL in the diagnosis of smoking-related interstitial lung diseases: Review of literature and analysis of our experienceDIAGNOSTIC CYTOPATHOLOGY, Issue 12 2008Joanna Domaga, Ph.D., a-Kulawik M.D. Abstract The group of interstitial lung diseases (ILDs) is formed by respiratory tract disorders, whose aetiology is unknown in the majority of cases, the clinical course differs and the prognosis is generally serious. Some of the ILDs have a potential relation to tobacco smoking and are known as smoking-related ILDs (sr-ILD). Bronchoalveolar lavage fluid (BALF) examination is one of the initial procedures in the diagnosis of ILD. Despite the fact that histological confirmation is the gold standard in ILD diagnosis in many studies, the number of reported biopsies was low. In this review we present the results of BALF examinations of patients with sr-ILD and discuss their value in the differential diagnosis with other types of ILD. An extremely high total cell count (about 50 × 106 cells) with significant predominance of pigmented alveolar macrophages is a characteristic pattern of BALF in sr-ILD. The greatest challenge in BALF cytology interpretation is to distinguish sr-ILD and idiopathic pulmonary fibrosis (IPF). IPF is characterised by an elevated proportion and absolute count of lymphocytes and neutrophils; in addition, BALF lymphocytosis is higher in non-specific interstitial pneumonia than in usual interstitial pneumonia (UIP). The population of alveolar macrophage of patients with sr-ILD differs markedly from the foamy and vacuolated cells that predominate in IPF/UIP. Thus, the absence of pigmented cells rather excludes sr-ILD and indicates other types of ILD. To summarise, the place of BALF in the diagnosis of sr-ILD seems to be established. Diagn. Cytopathol. 2008. © 2008 Wiley-Liss, Inc. [source] Looking beyond food aid to livelihoods, protection and partnerships: strategies for WFP in the Darfur statesDISASTERS, Issue 2007Helen Young The humanitarian crisis in Darfur remains extremely serious. The optimism that followed the signing of the Abuja Peace Accord was followed by a rapid deterioration in security on the ground in part associated with increasing factionalism in various rebel movements. This paper briefly reviews the evolution of the crisis, its impact on lives and livelihoods and the response by the World Food Programme (WFP) to June 2006. The major challenges and issues facing the food aid programme in the previous 18 months included: dealing with insecurity while maintaining or even extending programme outreach; the need to link protection with assistance more explicitly; and determining the wider impact of food aid programming on the processes and institutions linked with the conflict. The paper discusses the main strategic issues facing WFP in the future such as: integrating security and protection with needs assessments and operational decisions, broadening response strategies beyond food aid and bringing livelihoods to the fore, the need to review cost-efficiency, promoting partnerships and strengthening national and regional capacities. [source] Surge in treatment admissions related to methamphetamine use in Cape Town, South Africa: implications for public healthDRUG AND ALCOHOL REVIEW, Issue 2 2008ANDREAS PLÜDDEMANN Abstract Introduction and Aims. In the past decade, methamphetamine has become increasingly a drug of concern globally. The purpose of this study is to describe the changing trends in treatment admissions for methamphetamine abuse in Cape Town, South Africa and to highlight the implications of these changes for policy, practice and research. Design and Methods. Data were collected on admissions for drug abuse treatment through a regular monitoring system involving drug treatment centres and programmes in Cape Town every 6 months as part of the South African Community Epidemiology Network on Drug Use (SACENDU). A one-page form was completed by treatment centre personnel to obtain demographic data, the patients' primary and secondary substances of abuse, the mode, frequency and age of first use of substance and information on prior treatment. Results. The results indicate that between 2004 and 2006 a dramatic increase in treatment admissions for methamphetamine abuse occurred, a large proportion of the methamphetamine patients are adolescents and that the drug is almost exclusively smoked. Discussion and Conclusions. The rapid increase in admissions for methamphetamine abuse is of great concern, particularly as the drug has a number of serious, often chronic, side effects and that a large proportion of the patients are adolescents. The implications for public health are discussed. [source] Predictive instantaneous optimal control of elastic structures during earthquakesEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 14 2003Kevin K. F. Wong Abstract A predictive instantaneous optimal control (PIOC) algorithm is proposed for controlling the seismic responses of elastic structures. This algorithm compensates for the time delay that happens in practical control applications by predicting the structural response over a period that equals the time delay, and by substituting the predicted response in the instantaneous optimal control (IOC) algorithm. The unique feature of this proposed PIOC algorithm is that it is simple and at the same time compensates for the time delay very effectively. Numerical examples of single degree of freedom structures are presented to compare the performance of PIOC and IOC systems for various time delay magnitudes. Results show that a time delay always causes degradation of control efficiency, but PIOC can greatly reduce this degradation compared to IOC. The effects of the structure's natural periods and the choice of control gains on the degradation induced by the time delay are also analyzed. Results show that shorter natural periods and larger control gains are both more sensitive and more serious to the degradation of control efficiency. Finally, a practical application of PIOC is performed on a six-story moment-resisting steel frame. It is demonstrated that PIOC contributes significantly to maintain stability in multiple degree of freedom structures, and at the same time PIOC has a satisfactory control performance. Copyright © 2003 John Wiley & Sons, Ltd. [source] The Role of Intraoperative Transesophageal Echocardiography in Heart TransplantationECHOCARDIOGRAPHY, Issue 7 2002Paval Romano M.D. The number of centers that perform heart transplants has increased rapidly in recent years. Although transthoracic and transesophageal echocardiography (TTE and TEE) are utilized frequently to diagnose and manage cardiac complications commonly found in this population postoperatively, little has been written about the routine use of intraoperative TEE. Intraoperative echo is ideally suited to identify acute complications during cardiac transplantation. This can include immediate signs of rejection, valvular abnormalities, and mechanical complications related to the surgical procedure. Many of these patients might require ventricular assist devices (VAD) to provide circulatory support, and intraoperative TEE can be used to verify correct positioning of the VAD hardware. In addition, many of the chronic complications that patients with heart transplants are at risk for may be serious yet asymptomatic. Therefore, a high quality, complete intraoperative echocardiographic study might serve as an important baseline to compare postoperative changes. [source] Converting visual census data into absolute abundance estimates: a method for calibrating timed counts of a sedentary insect populationECOLOGICAL ENTOMOLOGY, Issue 4 2003Ho Jung S. Yoo Abstract., 1.,Visual surveys for small organisms on complex substrates often yield serious underestimates of true counts. When both visual counts (relative estimates of abundance) and absolute counts can be obtained from the same sample, however, the visual counts can be calibrated such that absolute estimates can be obtained in the future from visual surveys alone. 2.,A method is presented for converting quick, timed, visual counts of a sedentary insect on a shrub into absolute estimates of abundance. 3.,Analogies were drawn from simple, well-known predation theories to develop a two-parameter non-linear model. Parameter estimates were obtained by both inverse prediction and direct estimation methods; the latter were found to yield more accurate predictions of absolute abundance. 4.,The calibration model is mechanistic in its approach, and thus has potential for application in other systems in which all individuals are visible, but able to be missed during timed counts. [source] Jungle Law in the Orchard: Comparing Globalization in the New Zealand and Chilean Apple IndustriesECONOMIC GEOGRAPHY, Issue 4 2002Megan K. L. McKenna Abstract: Restructuring in the global apple market is leading to a pronounced tightening in the competitive spaces occupied by Southern Hemisphere producers. For New Zealand and Chile, the world's two most successful apple-exporting countries, significant challenges are presented by projected industry trends, such as declining profitability in the global industry, increased world production, and the continued static demand in key markets. In particular, falling prices in Europe and North America for many key varieties and concomitant lower returns to growers are threatening serious and pervasive impacts. This article explores some of these challenges in the context of the significantly different positions occupied by New Zealand and Chile within the global fresh fruit and vegetable complex. An analysis of the two countries' industries, particularly comparing issues of regulation and innovative varietal development, shows that global food complexes have highly variable spatial expressions, given their process-based nature and underlying dynamics of contestation. Focusing on the increased competition between the New Zealand and Chilean apple industries, the discussion sheds light on wider emerging competitive dynamics within the global fruit industry. The example of the recent Pacific Rose crisis, which involved Chilean "theft" of an exclusive New Zealand apple variety, is used to illustrate the emergence of "jungle law" in the Southern Hemisphere apple industries. [source] Distributional effects of WTO agricultural reforms in rich and poor countriesECONOMIC POLICY, Issue 50 2007Thomas W. Hertel SUMMARY WTO agricultural reforms Rich countries' agricultural trade policies are the battleground on which the future of the WTO's troubled Doha Round will be determined. Subject to widespread criticism, they nonetheless appear to be almost immune to serious reform, and one of their most common defences is that they protect poor farmers. Our findings reject this claim. The analysis conducted here uses detailed data on farm incomes to show that major commodity programmes are highly regressive in the US, and that the only serious losses under trade reform are among large, wealthy farmers in a few heavily protected sub-sectors. In contrast, analysis using household data from 15 developing countries indicates that reforming rich countries' agricultural trade policies would lift large numbers of developing country farm households out of poverty. In the majority of cases these gains are not outweighed by the poverty-increasing effects of higher food prices among other households. Agricultural reforms that appear feasible, even under an ambitious Doha Round, achieve only a fraction of the benefits for developing countries that full liberalization promises, but protect the wealthiest US farms from most of the rigors of adjustment. Finally, the analysis conducted here indicates that maximal trade-led poverty reductions occur when developing countries participate more fully in agricultural trade liberalization. , Thomas W. Hertel, Roman Keeney, Maros Ivanic and L. Alan Winters [source] Analysis of GaInAsP laser diodes degraded by light absorption at an active layer of the facetELECTRONICS & COMMUNICATIONS IN JAPAN, Issue 2 2010Hiroyuki Ichikawa Abstract Electrostatic discharge-induced degradation is one of the serious reliability problems of GaInAsP/InP laser diodes. The authors have conducted an analysis of electrostatic discharge-induced degradation, and have elucidated the principal degradation mechanism. The main cause of degradation is heating by light absorption at the active layer of the facet. This phenomenon is similar to the catastrophic optical damage that occurs in GaAs-based high-power laser diodes. The problem has become more serious with the recent tendency to high power demand. Therefore, technology to suppress against degradation is extremely important. Focusing on facet coating, which is one of the key processes to suppress facet degradation, we demonstrated that facet degradation can be successfully suppressed by inserting an ultrathin aluminum layer between the semiconductor and the dielectric coaling films. This effect is caused by a reduction of surface recombination. This degradation suppression technology has the potential to be applied not only to GaInAsP/InP laser diodes, but to any InP-based laser diodes. © 2010 Wiley Periodicals, Inc. Electron Comm Jpn, 93(2): 32,38, 2010; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/ecj.10196 [source] | ||||||||||||||||||||||||||||||||||||||||||||||