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Third Month (third + month)
Selected AbstractsThe Effect of Beta-Blocker (Carvedilol) Therapy on N-Terminal Pro-Brain Natriuretic Peptide Levels and Echocardiographic Findings in Patients with Congestive Heart FailureECHOCARDIOGRAPHY, Issue 2 2007Fuat Gundogdu M.D. Background: The favorable effects of beta-blockers on decreasing mortality in contemporary heart failure management have been demonstrated in recent years. N-terminal pro-brain natriuretic (NT-proBNP) peptide levels increase in patients with heart failure. The purpose of this study was to investigate the correlation between the NT-proBNP levels and echocardiographic findings for the patients who received carvedilol therapy in addition to standard therapy for congestive heart failure. Methods and Results: A total of 25 patients with symptomatic congestive heart failure and 25 healthy individuals were enrolled in the study. Before introducing beta-blocker into their therapy regimens, baseline transthoracic echocardiography recordings were made and venous blood samples were drawn for establishing NT-proBNP levels. The patients were administered with a minimum dose of carvedilol. Three months after reaching the maximum tolerable dose, blood samples were drawn from the patients once again for NT-proBNP measurements, and transthoracic echocardiography was performed. There was a significant drop in plasma NT-proBNP levels at the end of the study in comparison to the baseline values (baseline: 381.20±35.06 pg/mL, at the end of the third month: 254.44±28.64 pg/mL; P < 0.001). While left ventricular end-diastolic and end-systolic diameters were observed to have significantly decreased as a result of the therapy (P < 0.001), left ventricular ejection fraction (P<0.001) was established to have increased significantly. Conclusions: Carvedilol therapy resulted in a marked decrease in plasma NT-proBNP levels and increase left ventricular ejection fraction in patients with congestive heart failure. [source] The Evaluation of Thyroid Functions, Thyroid Antibodies, and Thyroid Volumes in Children with Epilepsy during Short-Term Administration of Oxcarbazepine and ValproateEPILEPSIA, Issue 11 2006Ali Cansu Summary:,Purpose: The aim of this study was to evaluate the effects of short-term oxcarbazepine (OXC) and valproate (VPA) monotherapy on thyroid functions in children. Methods: Fifty-five newly diagnosed epileptic children with normal thyroid functions (confirmed with the thyrotropin releasing hormone stimulation test) participated in this study. VPA treatment was started in 30 patients and OXC in 25 patients. Serum thyroxine (T4), free thyroxine (fT4), triiodothyronine (T3), free triiodothyronine (fT3), reverse T3 (rT3), thyroid peroxidase antibodies (TPO-ab), and urine iodine levels were evaluated at baseline and at the third and sixth months of therapy. Results: In the OXC group, serum T4, fT4, T3, fT3, and rT3 levels were found to be decreased at the third and sixth months, the differences were significant compared to the baseline values except for fT3 levels at the third month and fT4 and rT3 levels at the sixth month (p < 0.05). At the sixth month, serum T4 level dropped below the normal reference value in 8 (32%), fT4 in 5 (20%), T3 in 4 (16%), and fT3 in 3 (12%) patients. In the VPA group, mean T4, fT4, T3, fT3, and rT3 levels at 3 and 6 months remained similar compared to the baseline values (p > 0.05). Mean serum thyroid stimulating hormone levels increased significantly at the sixth month compared to the baseline values in the VPA group (p < 0.05) while it remained unchanged in the OXC group (p > 0.05). There was no effect of either drug on urinary iodine excretion and serum TPO-ab levels remained in normal ranges throughout the study. Conclusions: In this prospective study, it is documented that children under short-term OXC or VPA therapy showed altered thyroid functions similar to the changes observed after long-term treatment. Although, the clinical significance of these results need to be evaluated with future studies, this observation of altered thyroid functions points out that thyroid functions may need to be monitored closely in children receiving antiepileptic treatment, even in the short-time interval. [source] Serum transferrin receptor, ferritin, and reticulocyte maturity indices during the first year of life in ,large' preterm infantsEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2007Vassiliki Schiza Abstract Background:, Preterm infants are at risk of developing iron deficiency; among the iron status and hemopoiesis indices the serum transferrin receptor (sTfr) has been shown to be a useful indicator in assessing iron status, while immature reticulocyte production is regarded as an estimator of erythropoiesis. Objective:, To investigate age-related changes in iron status infants born ,moderately' preterm, with a gestational age (GA) of 32,36 wk, and identify associations between sTfr and other hematological and biochemical iron indices. Design:, Hospital-based prospective, longitudinal study in preterm infants. Methods:, Iron and erythropoiesis parameters were evaluated in 181 formula-fed preterm infants at 2 and 6 wk and 3, 6, 9, and 12 months chronological age. Hemoglobulin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), reticulocytes, serum iron (sFe), serum ferritin (sFer), sTfr, and reticulocyte subpopulations were measured. Results:, A total of 756 measurements were performed. After an initial decline, Hb rose from month 3 to 12 of life. SFe and sFer and immature reticulocyte count decreased from the second week to the third month and remained stable thereafter. STfr was lower up to 6 wk and stable from month 3 to 12. Iron deficiency anemia (IDA) was found in 5.5% of infants. In 76 measurements sFer was <12 ,g/L, implying storage iron deficiency (SID). A negative correlation was observed between sTfr and other indices of iron status such as Hb, Hct, MCV, sFe, and sFer. Infants with sFer <12 ,g/L had lower sTfr than those with sFer >12 ,g/L. Reticulocyte production was positively associated with STfr, but this association was dependent on the chronological age of the infant. Conclusion:, Iron depletion is common in formula-fed preterm (32,36 wk GA) infants between month 3 and 12 of life. STfr appears to be an indicator of iron status in preterm infants during the first year of life. [source] Effect of Autogenic Training on Drug Consumption in Patients With Primary Headache: An 8-Month Follow-up StudyHEADACHE, Issue 3 2003Terezia Zsombok MD Objective.,To examine the effects of Schultz-type autogenic training on headache-related drug consumption and headache frequency in patients with migraine, tension-type, or mixed (migraine plus tension-type) headache over an 8-month period. Background.,Behavioral treatments often are used alone or adjunctively for different types of headache. There are, however, only a few studies that have compared the efficacy and durability of the same treatment in different types of primary headache, and the effects of treatment on headache-related drug consumption rarely have been assessed even in these studies. Methods.,Twenty-five women with primary headache (11 with mixed headache, 8 with migraine, and 6 with tension-type headache) were evaluated via an open-label, self-controlled, 8-month, follow-up study design. After an initial 4 months of observation, patients began learning Schultz-type autogenic training as modified for patients with headache. They practiced autogenic training on a regular basis for 4 months. Based on data from headache diaries and daily medication records, headache frequencies and the amounts of analgesics, "migraine-specific" drugs (ergots and triptans), and anxiolytics taken by the patients were compared in the three subgroups over the 8-month period. Results.,From the first month of implementation of autogenic training, headache frequencies were significantly reduced in patients with tension-type and mixed headache. Significant reduction in frequency was achieved in patients with migraine only from the third month of autogenic training. Decreases in headache frequencies were accompanied by decreases in consumption of migraine drugs and analgesics resulting in significant correlations among these parameters. Reduction in consumption of anxiolytic drugs was more rapid and robust in patients with tension-type headache compared to patients with migraine, and this outcome failed to show any correlation with change in headache frequency. Conclusion.,Schultz-type autogenic training is an effective therapeutic approach that may lead to a reduction in both headache frequency and the use of headache medication. [source] Peginterferon-alpha-2b plus ribavirin therapy in patients with chronic hepatitis C as assessed by a multi-institutional questionnaire in JapanHEPATOLOGY RESEARCH, Issue 6 2010Tatsuya Ide Background and aim:, There has so far been no questionnaire report on patients who were treated with peginterferon plus ribavirin (PEG IFN+RBV) therapy. The purpose of this study was to investigate the problems of this therapy by a questionnaire survey. Patients and methods:, A survey of 681 patients with chronic hepatitis C who received treatment with PEG IFN+RBV was conducted in the Kyushu region of Japan. Using an original questionnaire, the survey was conducted prior to the treatment, during the third month of treatment, at the completion of treatment or the discontinuation of treatment, and at 6 months after the completion of treatment. Results:, It was indicated that the patients had a high level of comprehension and understanding of chronic hepatitis C and PEG IFN+RBV treatment. However, the results also indicated that patients had a high level of anxiety. Side effects were adequately dealt with by physicians. However, dermatological symptoms were not adequately explained to the patients, although they were the second most severe side-effect. It was also revealed that side-effects were most distressing during the first and second months after the start of treatment. Conclusion:, The questionnaire survey provided new information that has never been reported. It is believed that understanding this information is important for future treatment. [source] Comparison of efficacy of azithromycin vs. doxycycline in the treatment of rosacea: a randomized open clinical trialINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2008Maryam Akhyani MD Background, Rosacea is a common inflammatory disorder of the skin. Systemic antibiotics currently used in the treatment of rosacea are sometimes associated with uncomfortable side effects. Therefore, a need for an effective agent with few side effects and good patient compliance exists. Azithromycin, a macrolide antibiotic with prolonged mode of action, has recently been found to be an effective alternative in the treatment of inflammatory acne. Methods, For evaluation of the efficacy of azithromycin in the treatment of rosacea, we planned a randomized, open, clinical trial study to compare the efficacy of azithromycin with doxycycline in the treatment of this disease. Sixty-seven patients were randomized to receive either azithromycin 500 mg thrice weekly (on Monday, Wednesday, and Saturday) in the first, 250 mg thrice weekly (on Monday, Wednesday, and Saturday) in the second, and 250 mg twice weekly (on Tuesday, and Saturday) in the third month. The other group was given doxycycline 100 mg/day for the three months. Clinical assessment was made at baseline, at the end of first, second, third, and 2 months after treatment. Side affects were recorded. The limitation of this study is that there was no blindness. Results, Statistically significant improvement was obtained with both drugs. Neither drug was shown to be more effective than the other. In the azithromycin group four patients had diarrhea, while epigastric burning was seen in two patients using doxycycline. Conclusion, This study indicates that azithromycin is at least as effective as doxycycline in the treatment of rosacea. [source] Quality changes of fish burgers prepared from deep flounder (Pseudorhombus elevatus Ogilby, 1912) with and without coating during frozen storage (,18 °C)INTERNATIONAL JOURNAL OF FOOD SCIENCE & TECHNOLOGY, Issue 2 2010Maryam Mahmoudzadeh Summary In the present study, chemical and sensory qualities of fish burgers prepared from deep flounder (Pseudorhombus elevatus Ogilby, 1912) with and without coating (Group A and Group B, respectively) or batter and breading materials were determined during frozen storage at ,18 °C for 5 months. According the statistical results, Total volatile base nitrogen of two groups increased significantly (P < 0.05) but a significant decrease (P < 0.05) was observed at the third month for Group A. Thiobarbituric acid value of Group A decreased significantly (P < 0.05) with the storage time from 1.01 to 0.22, whereas a significant increase (P < 0.05) was observed for Group B from 0.15 to 0.62 at the end of storage time. There were significant differences of pH in either the Group A or Group B between the beginning and end of the storage periods (P < 0.05). Parameters of colour, texture, taste and general acceptability for two groups decreased (P < 0.05) but Group B indicated better scores than Group A at the end of the storage period. [source] Outcome of an oral health outreach programme for preschool children in a low socioeconomic multicultural areaINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2008INGER WENNHALL Background., Despite a significant reduction in the prevalence of dental caries, childhood tooth decay is still a public health problem in both developed and developing countries. Objective., The aim of this study was to evaluate the caries preventive effect of an oral health programme for preschool children living in a low socioeconomic multicultural area in the city of Malmö, Sweden. Methods., Eight hundred and four 2-year-old children were enrolled and recalled every third month between ages 2 and 3 and semi-annually between ages 3 and 5 years. From an outreach facility, parents were instructed on oral health with a focus on toothbrushing and diet, and provided fluoride tablets free of charge. Participants completed a clinical examination and a structured interview at age of 5 years, at which point 651 children (81%) remained in the programme. The results of the intervention group were compared with a non-intervention reference group consisting of 201 5-year-old children from the same district. Results., In the intervention group, 96% attended four or more of their scheduled appointments, and mean caries prevalence was significantly lower than in the reference group (5.4 deft vs. 6.9 deft; P < 0.001). The prevented defs fraction was 27%. Parents' daily assistance with toothbrushing and administering fluoride tablets was significantly better in the intervention group than in the reference group (P < 0.05). Conclusion., This study demonstrated that the early start of oral health programme had a significant beneficial effect on caries prevalence after 3 years. [source] Stones in anomalous kidneys: Results of treatment by shock wave lithotripsy in 150 patientsINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2004LUTFI TUNC Abstract Objective:, To determine the efficacy of shock wave lithotripsy (SWL) in anomalous kidneys. Methods:, From October 1990 to October 2002, 150 patients (93 men and 57 women) with anomalous urinary tracts, including 45 horseshoe kidneys, 57 duplex kidneys, 30 malrotated kidneys, 14 pelvic and four crossed ectopic kidneys were treated with SWL for urolithiasis at the Gazi University Faculty of Medicine. Shock wave lithotripsy was performed with Siemens Lithostar plus (Siemans, Erlanger, Germany) device and all procedures were carried under fluoroscopic control. Results:, The mean shock wave number and intensity received by the patients was 3770 (range, 1380,4100) shocks and 18.4 (range, 16.1,19) kV per session, respectively. The minimum success rate was obtained in patients with lower calyceal (50%) followed by middle calyceal (60%) calculi. The stone-free rate decreased and the number of sessions per patient increased with increasing stone diameter (dm). In patients with a stone dm > 30 mm, only 34% could be stone-free, compared to a rate of 92% for calculi dm < 10 mm. The overall stone free rate at the third month was 68%. The best stone-free rates were obtained in patients with ureteral duplication (80.7%). The stone-free rates in horseshoe, malrotated, pelvic and crossed ectopic kidneys were found to be 66.7%, 56.7%, 57.2% and 25%, respectively. Conclusion:, Shock wave lithotripsy might be an effective and minimally invasive treatment alternative in stone-bearing anomalous kidneys. The type of anomaly, stone burden and localization seem to be the main parameters effecting the treatment success. [source] Neurolytic phenol blockade of the obturator nerve for severe adductor spasticityACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2010T. AKKAYA Background: In this study, we present the 3-month follow-up results of a retrospective analysis of obturator nerve (ON) phenol neurolysis performed between 2000 and 2007 in patients with adductor spasticity. Methods: The study was performed by retrospective investigation of the clinical follow-up results of 80 ON phenol treatments in 62 patients. Neurolysis using 5,10 ml 6% phenol was applied with the guidance of fluoroscopy and a peripheral nerve stimulator. Pain, spasticity and hygiene were evaluated and the hip abduction range of motion (ROM) was measured at the end of the first week and in the first, second and third months following the intervention. Results: The visual analogue scale scores decreased significantly in the first week, first month and the second month, but reached their initial values in the third month. A drastic increase in the ROM values was shown in hip abduction in the first week, first month and second month. An increase in the Ashworth Scale values was observed in the second and third months, but they did not reach their initial values. The hygiene score decreased drastically in the first week and the first and second months, but worsened in the third month. The success rate in nerve localization during ON neurolysis was 100%. Conclusion: ON phenol blockade with fluoroscopy and peripheral nerve stimulator guidance in patients with adductor spasticity led to a decrease in spasticity and pain with an increase in the ROM of the hip and better hygiene with an efficacy lasting for about 3 months. [source] Studying the satisfaction of patients on the outcome of an aesthetic dermatological filler treatmentJOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2008Lúcia Helena Fávaro De Arruda MD Summary Background, Many factors contribute to extend productive life in the modern world. Competition makes people worry about physical appearance, mostly in respect to facial and skin aging. This has motivated new developments in cosmetic dermatology and the need of evaluating patient satisfaction with the new proposed treatments. Poll questionnaire has been used for such evaluation, and the analysis of the electroencephalogram (EEG) mapping obtained while the patient answers the satisfaction questionnaire may render the results less subjective. Objectives, The purpose of this paper is to study the satisfaction of a group of 33 women (mean age, 44 years) treated with hyaluronic acid filling of nasolabial folding or lips, combining the EEG brain mapping and questionnaire techniques. Methods, At the third month of evaluation, two networked personal computers were used for the EEG recording and for presenting the patient with a questionnaire about her well-being feeling; self-evaluation of her face; her satisfaction with the results of the aesthetic treatment; how the family, friends, and people at work evaluated the result of the treatment; and her decision to repeat the treatment and to recommend it to friends and family. Results, Poll results showed that patients were feeling well and were satisfied with the results of the aesthetic treatment. Furthermore, the regression EEG mappings showed patients to be satisfied with their appearance and with the treatment involving similar brain areas. Conclusion, Patients decided to undergo the treatment because they were already considering it (54%) or because they were dissatisfied with their lips or nasolabial folding (52%). The fact that the treatment was free of charge solidified the decision. Patients consider themselves as good-looking and they wanted to preserve such a condition. [source] First summer growth predetermined in anadromous and resident brook charrJOURNAL OF FISH BIOLOGY, Issue 2 2007E. Chernoff Early growth of wild, anadromous and non-anadromous (resident) brook charr Salvelinus fontinalis was compared under controlled laboratory conditions. Offspring were collected as they emerged from natural redds in the Miramichi River, New Brunswick, Canada. Anadromous offspring were initially longer and heavier than residents. Anadromous offspring had lower specific growth rates during their first 2 months post-emergence, but surpassed residents by the third month. Consequently, anadromous offspring remained larger at the end of 3 months and it is concluded that they had a predetermined, maternal and genetic advantage related to body size, rather than an environmentally determined advantage during their first summer of growth. Other studies hypothesize that juvenile development affects life-history strategy adopted as adults, which suggests anadromy in this population may be, at least in part, predetermined by maternal and genetic effects. [source] ALKALOID COMPOSITION OF LUPINUS CAMPESTRIS FROM MEXICOJOURNAL OF FOOD BIOCHEMISTRY, Issue 2 2001J. MARTÍNEZ-HERRERA ABSTRACT The content of quinolizidine alkaloids (QA) in Lupinus campestris, Fabaceae family, was analyzed by Gas Chromatography-Mass Spectrometry (GC-MS), Samples of various organs of Lupinus campestris collected at different monthly stages of the growing plant, were subjected to extraction in a Merck Extrelut column. The quinolizidine alkaloid patterns of stems, leaves, flowers, pods and seeds were assessed and then identified and quantified by GC. Alkaloid structures were identified according to their mass fragmentation patterns, in combination with their indicative Kovats retention index. Alkaloids found in several developmental stages of the plant were mainly: aphyllidine, 5, 6-dehydrolupanine, aphylline, dehydro-oxosparteine, lupanine, ,-isolupanine, hydroxyaphylline and hydroxyaphyllidine, plus two alkaloids that -were not identified. During the third month the relative abundance of total alkaloids were highest. The main alkaloids found in seeds were hydroxyaphylline and hydroxyaphyllidine. [source] Patterns of breastfeeding in a UK longitudinal cohort studyMATERNAL & CHILD NUTRITION, Issue 1 2007David Pontin Abstract Although exclusive breastfeeding for the first 6 months of infant life is recommended in the UK, there is little information on the extent of exclusive breastfeeding. This study has taken the 1996 and 2003 World Health Organization (WHO) definitions of breastfeeding and investigated breastfeeding rates in the first 6 months of life in infants born to mothers enrolled in a longitudinal, representative, population-based cohort study , the Avon Longitudinal Study of Parents and Children (ALSPAC). Information about breastfeeding and introduction of solids was available for 11 490 infants at 6 months of age (81% of live births). Exclusive breastfeeding declined steadily from 54.8% in the first month to 31% in the third, and fell to 9.6% in the fourth month mainly due to the introduction of solids to the infants. In the first 2 months, complementary feeding (breastmilk and solid/semi-solid foods with any liquid including non-human milk) was used in combination, and declined from 22% in the first month to 16.8% in the second due to a switch to exclusive commercial infant formula feeding. Replacement feeding (exclusive commercial infant formula or combined with any liquid or solid/semi-solid food but excluding breastmilk) increased steadily from 21.9% in the first month to 67.1% by the seventh. This obscured the change from exclusive commercial infant formula feeding only to commercial infant formula feeding plus solids/semi-solids, a change which started in the third month and was complete by the fifth. Using categories in the 1996 and 2003 WHO definitions, such as complementary feeding and replacement feeding, presented difficulties for an analysis of the extent of breastfeeding in this population. [source] Cutaneous zygomycosis: a case report and review of Japanese reportsMYCOSES, Issue 7-8 2001M. Kobayashi Rhizopus microsporus var. microsporus; Hautinfektion; abwehrgeschwächter Patient. Summary. A 69-year-old man, a carpenter with idiopathic thrombopenic purpura and interstitial pneumonia, was treated with steroid pulse therapy and antibiotics. On the seventh day of steroid therapy, a conglomeration of papules, vesicles and pustules appeared in an area of the left buttock in contact with his napkin. In a Parker KOH specimen of the crust of the lesion, many non-septate hyphae were seen, and culture of material obtained by biopsy yielded Rhizopus microsporus var. microsporus. Ketoconazole cream was applied topically for 1 week, and the exanthema healed. After the third month of in-patient treatment, the patient's overall condition had returned to normal, and he was discharged. Cutaneous zygomycosis is a rare disease, and only 19 cases have been reported in Japan. Its characteristics, as reported in these cases, have been collected and collated. Zusammenfassung., Ein 69 Jahre alter Mann, ein Zimmermann mit idiopathischer thrombopenischer Purpura und interstitieller Pneumonie, begann eine Steroid-Pulstherapie und Antibiotika-Therapie. Am siebten Tag der Steroidgabe bildete sich im Bereich der linken Gesäßhälfte, an der Kontaktstelle mit einer Windel, eine Ansammlung von Papeln, Bläschen und Pusteln. Im Parker-KOH-Präparat von Proben der Blasenkrusten fanden sich zahlreiche nicht-septierte Hyphen, und in Kultur wurde Rhizopus microsporus var. microsporus nachgewiesen. Eine Woche lang wurde lokal Ketoconazol-Creme aufgetragen, und das Exanthem heilte ab. Nach dem dritten Monat der Hospitalisierung normalisierte sich das Befinden des Patienten und er konnte entlassen werden. Die Haut-Zygomykose ist sehr selten, und in Japan wurden bisher nur 19 Fälle berichtet. Diese Kasuistiken wurden gesammelt und ausgewertet. [source] Hypospadias and maternal exposures to cigarette smokePAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2005Suzan L. Carmichael Summary The few previous studies of hypospadias and smoking have suggested either no association or a reduced risk. This study, which uses data from the National Birth Defects Prevention Study, a multi-state, population-based case,control study, includes data on males born with severe hypospadias (i.e. the urethra opens at the penile shaft, scrotum or perineum) from 1997 to 2000. Non-malformed, liveborn male controls were selected randomly from birth certificates or from birth hospitals. Maternal interviews were completed by telephone with 453 case mothers and 1267 control mothers. Maternal smoking was not associated with hypospadias risk. For example, during the third month of pregnancy, smoking < 0.5 pack/day had an odds ratio (OR) of 1.1 [95% CI 0.6, 1.9]; 0.5 pack/day, 0.6 [0.4, 1.1]; and ,,1 pack/day, 0.8 [0.4, 1.6]. Exposure to any secondhand smoke at home during the third month of pregnancy showed an OR of 0.6 [95% CI 0.4, 1.0], and exposure at work or school, an OR of 0.7 [0.5, 1.1]. Similar risks were observed for other months during the periconceptional period, and adjustment for several potential confounders did not substantially alter results. This analysis does not confirm a recent report suggesting that maternal smoking is associated with a reduced risk of having offspring with hypospadias. [source] Risk factors for non-syndromic holoprosencephaly in the National Birth Defects Prevention Study,,§AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 1 2010Eric A. Miller¶ Abstract Holoprosencephaly (HPE) is a complex structural brain anomaly that results from incomplete cleavage of the forebrain. The prevalence of HPE at birth is low, and risk factors have been difficult to identify. Using data from a large multi-state population-based case-control study, we examined risk factors for non-syndromic HPE. Data from maternal telephone interviews were available for 74 infants with HPE and 5871 controls born between 1997 and 2004. Several characteristics and exposures were examined, including pregnancy history, medical history, maternal diet and use of nutritional supplements, medications, tobacco, alcohol, and illegal substances. We used ,2 -tests and logistic regression (excluding women with pre-existing diabetes) to examine associations with HPE. Except for diet (year before pregnancy) and sexually transmitted infections (STIs) (throughout pregnancy), most exposures were examined for the time period from the month before to the third month of pregnancy. HPE was found to be associated with pre-existing diabetes (,2,=,6.0; P,=,0.01), aspirin use [adjusted odds ratio (aOR),=,3.4; 95% confidence interval (CI) 1.6,6.9], lower education level (aOR,=,2.5; 95%CI 1.1,5.6), and use of assisted reproductive technologies (ART) (crude OR,=,4.2; 95%CI 1.3,13.7). Consistent maternal folic acid use appeared to be protective (aOR,=,0.4; 95%CI 0.2,1.0), but the association was of borderline statistical significance. While some of these findings support previous observations, other potential risk factors identified warrant further study. Published 2010 Wiley-Liss, Inc. [source] The Development of the Epicardium in the Sturgeon Acipenser naccariiTHE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 10 2009José M. Icardo Abstract This article reports on the development of the epicardium in alevins of the sturgeon Acipenser naccarii, aged 4,25 days post-hatching (dph). Epicardial development starts at 4 dph with formation of the proepicardium (PE) that arises as a bilateral structure at the boundary between the sinus venosus and the duct of Cuvier. The PE later becomes a midline organ arising from the wall of the sinus venosus and ending at the junction between the liver, the sinus venosus and the transverse septum. This relative displacement appears related to venous reorganization at the caudal pole of the heart. The mode and time of epicardium formation is different in the various heart chambers. The conus epicardium develops through migration of a cohesive epithelium from the PE villi, and is completed through bleb-like aggregates detached from the PE. The ventricular epicardium develops a little later, and mostly through bleb-like aggregates. The bulbus epicardium appears to derive from the mesothelium located at the junction between the outflow tract and the pericardial cavity. Strikingly, formation of the epicardium of the atrium and the sinus venosus is a very late event occurring after the third month of development. Associated to the PE, a sino-ventricular ligament develops as a permanent connection. This ligament contains venous vessels that communicate the subepicardial coronary plexus and the sinus venosus, and carries part of the heart innervation. The development of the sturgeon epicardium shares many features with that of other vertebrate groups. This speaks in favour of conservative mechanisms across the evolutionary scale. Anat Rec, 2009. © 2009 Wiley-Liss, Inc. [source] Dose-Dependent Immunohistochemical Changes in Rat Cornea and Retina after Oral Methylphenidate AdministrationANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 2 2009E. Tunc Summary Methylphenidate hydrochloride (MPH), more commonly known as Ritalin, is a piperidine derivative and is the drug most often used to treat attention deficit/hyperactivity disorder, one of the most common behavioural disorders of children and young adults. The aim of this study was to investigate dose-dependent immunohistochemical Dopamine 2 receptor (D2) expression and apoptosis in the rat cornea and cornea. In this study, 27 female pre-pubertal Wistar albino rats, divided into three different dose groups (5, 10 and 20 mg/kg) and their control groups, were used. They were treated orally with methylphenidate dissolved in saline solution for 5 days per week during 3 months. At the end of the third month, after perfusion fixation, eye tissue was removed. Paraffin sections were collected for immunohistochemical and terminal deoxynucleotidyl-transferase-mediated dUTP-biotin nick end labelling assay studies. In our study, we observed that the cornea D2 receptor reactivity showed a dose-related increase after MPH treatment, especially in basal cells of the epithelium and a dose-dependent decrease in the retinal ganglion cell which was statistically meaningful. Analysis of the cornea thickness results showed no meaningful difference between groups. Apoptotic cell number showed a meaningful increase in the high dose treated group compared to the other groups of the study. The data suggest that Ritalin has degenerative effect on the important functional part of the eye, such as cornea and retina and its activating dopaminergic mechanism via similar neuronal paths, functionally and structurally, to induce morphological changes. As a result, we believe that this morphological changes negatively effecting functional organization of the affected cornea and retina. [source] Effect of mixed feeding schedules with varying dietary protein levels on the growth of sutchi catfish, Pangasius hypophthalmus (Sauvage) with silver carp, Hypophthalmichthys molitrix (Valenciennes) in pondsAQUACULTURE RESEARCH, Issue 7 2005Md Zulfikar Ali Abstract A 6-month feeding trial was conducted in field condition using 10 farm ponds (400,600 m2) to investigate the effect of mixed feeding schedules on the growth of sutchi catfish, Pangasius hypophthalmus with silver carp, Hypophthalmichthys molitrix. Fish were stocked at a ratio of 80:20 (sutchi catfish, 4.9±0.5 g: silver carp, 12.0±0.8 g) at the total rate of 25 000 ha,1. Two diets of high protein (30%, HP) and low protein (16%, LP) were prepared using locally available feed ingredients. Five different feeding schedules of high-protein diet continuously (HP), low-protein diet continuously (LP), 1-day low,protein/1-day high-protein diet (1LP/1HP), 7 days low,protein/7 days high-protein diet (7LP/7HP) and 14 days low,protein/14 days high-protein diet (14LP/14HP) were tested. The fish were fed twice daily at the rate of 15%, 10%, 8% and 5% of their body weight for first, second, third month and rest of experimental period respectively. Feeding rate was calculated only on the basis of sutchi catfish weight only and was adjusted every 2 weeks according to weight gain. Fish fed LP and HP on alternate day (1LP/1HP) resulted in significantly (P<0.05) higher growth rate, feed utilization and production among the treatments. However, there were no significant differences (P>0.05) between the growth rates and production of fish fed HP regularly and fish fed 7 days LP followed by 7 days HP (7LP/7HP). Fish maintained on LP grew the least. The feed conversion ratio (FCR) values for sutchi catfish ranged between 2.04 and 2.79 with feeding schedule 1LP/1HP showing the best FCR. The total production of fish (including silver carp) ranged between 8310 and 12 422 kg ha,1 6 months,1 with 1LP/1HP feeding schedule resulting in the highest production and net profit. The study demonstrated that feeding fish continuously with HP is less economical. Thus, for profitable sutchi catfish culture with silver carp, farmers can use the mixed feeding schedule of alternate day feeding of LP and HP as a means of reducing feed costs. [source] Host plant effects on the development and survivorship of the galling insect Neopelma baccharidis (Homoptera: Psyllidae)AUSTRAL ECOLOGY, Issue 3 2002M. M. Espírito-Santo Abstract In this study, the mortality factors acting upon the galling psyllid Neopelma baccharidis Burckhardt (Homoptera) caused by its host plant, Baccharis dracunculifolia De Candole (Asteraceae) were analysed. In March 1999, 982 galls of the same cohort were randomly marked on 109 individuals of B. dracunculifolia in the field. Galls were censused each month during their development, from April to August, and dead galls were collected and analysed for mortality factors. Gall dehiscence rates were calculated for each month. The major mortality source of N. baccharidis was gall dropping (13.2% of the original cohort), which is probably a normal outcome of previous mortality caused by the other factors observed in this study. Unknown factors killed 11.7% of this gall population and were ascribed to plant resistance during gall development. Empty galls represented 7.7% of the observed mortality and may be a consequence of egg retention or egg mortality/abortion related to variations in plant quality. Shoot mortality was high during the dry season and killed 7.5% of the galls, but this impact was minimized after the third month from gall formation due to the ability of nymphs to accelerate development and emerge from galls on dying shoots. However, the size of dehisced galls on dead shoots tended to be smaller, possibly affecting adult performance. Mortality of N. baccharidis attributed to B. dracunculifolia strongly controlled the galling insect population, killing 40.7% of the original cohort of galls. Plant-mediated mortality was caused by often neglected factors acting predominantly during the first 3 months of development, which are critical to gall survivorship. These results reinforce the importance of bottom-up forces in plant-insect systems. [source] Effect and persistency of botulinum toxin iontophoresis in the treatment of palmar hyperhidrosisAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2008Sanaz Davarian SUMMARY The purpose of this study was to investigate the efficacy and persistence of the hypohidrosis induced by iontophoresis of botulinum toxin type A in patients with palmar hyperhidrosis. Eight patients with severe palmar hyperhidrosis participated in this study. Iontophoresis of botulinum toxin was applied to the patients' dominant (right) hand and the other hand was the control treated with normal saline. Gravimetry and iodine,starch tests were performed to evaluate the rate of sweating. The evaluation sessions were at baseline, 2 and 4 days, 1, 2, 3, 4, 8 and 12 weeks after treatment. The patients were also asked to fill out the Dermatology Life Quality Index questionnaire at 2, 4, 8 and 12 weeks after treatment. The mean sweating rate significantly reduced at the first, second, third and fourth week and the second and third month (P < 0.05) after the treatment in the right hand, and the third and fourth week (P < 0.05) after treatment in the left hand. Iontophoresis of botulinum toxin rapidly induced a quick reduction of sweating rate for at least 3 months with no pain, muscle weakness or other side-effects. [source] Low-dose mifepristone in treatment of uterine leiomyoma: A randomised double-blind placebo-controlled clinical trialAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Madhu BAGARIA Aims: To evaluate the effect of low-dose mifepristone on leiomyoma-related symptoms, uterine and leiomyoma in women with symptomatic leiomyomata. Methods: In a double-blind placebo-controlled trial, 40 patients with symptomatic leiomyoma and normal endometrial histology were randomised to receive 10 mg mifepristone (group 1) or placebo (group 2) daily for three months. Leiomyoma-related symptoms, uterine, leiomyoma and largest leiomyoma volumes were assessed at baseline and every month for three months. Endometrial biopsy was repeated at the end of therapy. Results: Significant change was noticed between the two groups for mean menstrual blood loss (MBL) by first month. Menstrual blood loss declined by 94.8% in group 1 at three months and 84.2% patients attained amenorrhoea in this group. In group 1 complete relief of dysmenorrhoea occurred in significant number of women (80%) but only 33% patients got rid of pelvic pain. There was no change in these symptoms in group 1 Backache, urinary complaints and dyspareunia were not relieved in either group. Uterine, leiomyoma and largest leiomyoma volume declined by 26,32% in group 1 as compared to none in group 2, and this difference was statistically significant only by the end of the third month of therapy. Mean haemoglobin increased from 9.5 to 11.2 g/dL in group 1. In group 1, at the end of therapy, 63.1% of patients had endometrial hyperplasia without atypia. Conclusions: Ten milligrams mifepristone for three months is effective in reducing MBL, increasing haemoglobin and reducing uterine and leiomyoma volume with side-effect of endometrial hyperplasia. [source] Analysis of progression and survival after 10 years of a randomized prospective study comparing mitomycin-C and bacillus Calmette-Guérin in patients with high-risk bladder cancerBJU INTERNATIONAL, Issue 4 2007Truls Gårdmark OBJECTIVE To report the 10-year follow-up of a study randomizing between instillations of bacillus Calmette-Guérin (BCG) and mitomycin-C (MMC) for treating high-risk and not muscle-invasive urinary bladder cancer to assess progression, the need for more aggressive treatment and survival (cancer-specific and overall), as many of the published studies comparing different treatments for disease that is not muscle-invasive have a short follow-up. PATIENTS AND METHODS Between 1987 and 1992, 261 patients were included; they had frequently recurring Ta/T1G1,G2, T1G3 or primary Tis-dysplasia. The patients were randomized to treatment with either 40 mg of MMC or 120 mg of BCG (Danish strain 1331) given weekly for 6 weeks, then monthly up to a year and finally every third month for a further year. The 250 evaluable patients were followed using hospital files and national registers on causes of death. RESULTS The median follow-up for survivors was 123 months. The disease progressed in 58 (23%) of the patients, 34 in the MMC group and 24 in the BCG group (P = 0.26). Of the 140 patients who died, 68 were in the BCG and 72 in the MMC group (log-rank P = 0.98); most (95, 68%) died from other causes. CONCLUSION Based on the follow-up of the present patients it cannot be concluded that the drugs originally administered, MMC or BCG, differed in their effect on progression, need for subsequent treatment or survival. [source] Macular thickness alterations after cataract surgery determined by optical coherence tomographyACTA OPHTHALMOLOGICA, Issue 2009M ELEFTHERIADOU Purpose To evaluate macular thickness alterations with optical coherence tomography after phacoemulsification and posterior champer intraocular lens implantation. Methods In this prospective study,201 patients who underwent phacoemulsication(102 men and 99 women)with mean age 65±8years were included.Best corrected visual acuity,complete slit lamp examination with lens and OCT examination were performed in all patients before surgery and at one,three and six months postoperatively.Patients were divided into five groups:Group 1(control group-100 eyes):patients without any predisponding factors for cystoid macular edema,Group 2(15 eyes):patients with complicated surgery,Group 3(27 eyes):patients with epiretinal membrane,Group 4(35 eyes):patients with diabetes and Group 5(24 eyes):patients with glaucoma. Results The preoperative mean minimal foveal thickness(MMFT)in groups 1 and 2 was 204±24,m and 213±47,m respectively and had no significant changes throughout the follow up period(p>0,05). In groups 3,4 and 5 a significant increase of macular thickness was detected. In group 3 the preoperative MMTF was 248±72,m and at 1,3 and 6 months it was 263±86,m(p=0,01),240±30,m(p=0,18)and 270±64,m(p<0,01)respectively. In group 4 the preoperative MMTF was 219±39,m,after 1month the MMTF increased at 257±78,m(p=0,002),at 3months it was 231±46,m(p=0,005)and at the last examination at 6 months it was 236±49,m(p=0,005). In group 5 the initially MMTF(206±21,m)had significant increase in the first[213±30,m(p=0,07)]and in the third month[223±24,m(p=0,03)]. Conclusion Diabetic retinopathy, epiretinal membranes and glaucoma may predispose to increase in macular thickness after cataract surgery. [source] Short-term influence of antiglaucomatous medications on the ocular pulse amplitude (OPA) measured with the dynamic contour tonometer Pascal®ACTA OPHTHALMOLOGICA, Issue 2007M DETRY-MOREL Purpose: To assess the short and medium-term influence of antiglaucomatous treatment on the OPA value by DCT. Methods: Prospective non-randomized study including 35 eyes of 25 patients (mean age: 63±10,9 years) with newly diagnosed POAG or OHT and treated with latanoprost, bimatoprost or Cosopt®. The IOP and OPA were measured with GAT and DCT before starting the study and after 1, 3 and 6 months of treatment. Central corneal thickness (CCT), systolic, diastolic blood pressure (BP) and cardiac frequency were recorded. Pearson coefficient was used to assess correlations. Results: The mean GAT IOP was 25.0±5.6 mmHg at baseline, 17.7±3.6 mmHg, 17.9±3.2 mmHg and 17.6±3.3 mmHg at first,3 and 6 months post-treatment respectively (p<0.001). From a mean baseline IOP of 24.2±3.9 mmHg, the mean DCT IOP was 17.9±2.6 mmHg, 17.6±2.5 mmHg, 17.5±2.3 mmHg at 1,3 and 6 months (p<0.001). Both mean IOP GAT and DCT were correlated with CCT (p<0.05). GAT and DCT IOP were strongly correlated at all visits. The mean pretreatment OPA was 3.3±0.9 mmHg. It was significantly reduced to 2.6±0.7 mmHg at first month, 2.6±0.7 mmHg at third month and 2.8±0.6 mmHg at 6 month, without difference between the post-treatment visits (regression, p>0.05). The baseline OPA was significantly correlated with DCT IOP, systolic and diastolic BP. It was only correlated with BP at first month (p<0.05). The decreases in OPA and IOP were significantly correlated. Conclusions: Antiglaucomatous medications are associated with a significant short-term decrease in OPA which remains stable in the medium-term. [source] Insulin requirement in preschoolers treated with insulin pumps at the onset of type 1 diabetes mellitusACTA PAEDIATRICA, Issue 3 2009Agnieszka Szypowska Abstract The aim: The aim of this study is to analyze changes in the basal insulin requirement in preschoolers treated with insulin pump at the onset of T1DM, using system to calculate meal time insulin. Methods: 58 children (31 girls) under 6 years (mean age 3.3 ± 1.5 years) initiated on insulin pump therapy within 2 months after recognition of T1DM and treated at least for 1 year were analyzed during a follow-up period of 165 patient-years. Data was collected every 6 months: HbA1c, BMI SDS, diabetic ketoacidosis, severe hypoglycaemia, total daily insulin dose (TDD) and basal insulin. Results: Basal insulin rose from 10% in the third month and did not exceed 30% of TDD after 12 months (p<0.0001). In the third month, 46% of children were without basal insulin; this group included significantly older children (3.7 ± 1.4 vs. 2.8 ± 1.4 years; p = 0.01), which had lower TDD (0.33 ± 0.18 vs. 0.54 ± 0.23u/kg/d; p = 0.0007) than children with basal insulin. HbA1c persisted ,7.3%. Conclusion: In preschool children initiated on CSII therapy at the time of T1DM diagnosis the first year of treatment is critical for altering the basal insulin dose. Preschoolers with TDD lower than 0.5U/kg/d may not require basal insulin. Moreover, basal insulin did not exceed 30% of TDD in the first years after T1DM onset. [source] Comparison of efficacy of azithromycin vs. doxycycline in the treatment of acne vulgarisCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2005S. Kus Summary Acne vulgaris is a common inflammatory disorder of the skin. Oral antibiotics are known to be effective in its treatment. A randomized, investigator-blinded study was performed to compare the efficacy of azithromycin with doxycycline. Fifty-one patients were randomized to receive either azithromycin 500 mg/day on 3 consecutive days per week in the first, on 2 consecutive days per week in the second, and on 1 day per week in the third month. The other group was given doxycycline twice a day for the first month and once a day for the second and third months. Clinical assessment was made at baseline, at the end of first, second, third, and post-treatment first and second months. Side effects were recorded. Statistically significant improvement for the facial lesions were obtained with both drugs. Neither drug was shown to be more effective than the other. The beneficial effect continued until 2 months after treatment. In the azithromycin group three patients had diarrohea, while photosensitivity was seen in two patients using doxycycline. This study indicates that azithromycin is at least as effective as doxycycline in the treatment of acne. [source] Stent implantation in variant angina refractory to medical treatmentCLINICAL CARDIOLOGY, Issue 12 2006Dr Vicens Martí M.D. Abstract Background Vasospastic angina usually responds well to medical treatment. Hypothesis The present study describes our experience in patients who received a coronary stent because of recurrent variant angina refractory to medical treatment and evaluates stent implantation as an alternative treatment. Materials and methods Between March 1998 and February 2005, recurrent variant angina was diagnosed in 22 patients admitted to our coronary care unit. Of these, five patients (22.7%), were refractory to pharmacologic treatment. Coronary angiography and coronary stents were indicated. Clinical follow-up was 29 ± 6 months. Results Stenting was performed during diagnostic coronary angiography in two patients. In the other three patients, the stent was implanted 24,48 h later. We observed coronary spasm recurrences proximal or distal to the stent in four patients,two during the stent implantation procedure and the other two in the coronary care unit within 48 h post angioplasty. Three patients where treated with additional stenting and the fourth patient improved with pharmacologic treatment. During follow-up three patients remained asymptomatic. The fourth patient had diffuse in-stent restenosis in the third month, and the fifth patient showed a de novo lesion in the treated segment 2 years later. Conclusions Stent implantation in patients with recurrent variant angina refractory to medical treatment may be an alternative treatment in carefully selected, clinically unstable patients. Spasm recurrences may occur in other segments of the treated artery, probably due to the diffuse nature of the disease. Immediate and continued surveillance is recommended because of the risk of adverse clinical events. Copyright © 2006 Wiley Periodicals, Inc. Wiley Periodicals, Inc. [source] Population-based case,control study of oral ketoconazole treatment for birth outcomesCONGENITAL ANOMALIES, Issue 1 2005Zoltán Kazy ABSTRACT The objective of the study presented here was to check the effect of oral ketoconazole treatment on fetal development. Ketoconazole has been given a teratogenic classification of C by the US Food and Drug Administration, but human controlled epidemiological studies of the treatment's effects have not been reported. The occurrence of ketoconazole use in the second to third months of gestation was compared between cases with congenital abnormalities and their matched controls in the large population-based data set of the Hungarian Case,Control Surveillance of Congenital Abnormalities, 1980,1996. Birth weight and gestational age were evaluated in control newborn infants born to mothers with or without ketoconazole treatment. The case group comprised 22 843 cases with congenital abnormalities, while the control group contained 38 151 newborn infants without any defects. Six infants (0.03%) and 12 controls (0.03%) had mothers who had received oral ketoconazole treatment (prevalence odds ratio: with 95% confidence interval: 0.8, 0.3,2.2). No group of infants with congenital abnormalities had mothers with a higher incidence of use of the drug. The mean gestational age was somewhat longer while birth weight was somewhat larger in controls with ketoconazole treated mothers. Our study failed to demonstrate a higher rate of congenital abnormalities in infants with mothers who had received oral ketoconazole treatment during pregnancy. [source] | ||||||||||||||||||||||||||||||||||