Useful Addition (useful + addition)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

FS04.6 Dose/unit area and time , key factors influencing the elicitation capacity of MCI/MI

Claus Zachariae
The objective of the study was to investigate, using the Repeated Open Application Test (ROAT), two key parameters of exposure , allergen concentration (dose/unit area) and time in terms of the elicitation capacity of methylchloroisothiazolinone and methylisothiazolinone (MCI/MI) in MCI/MI-sensitised individuals and to explore the inter-relationship between these two key factors. The study was designed as a double-blind, placebo-controlled, dose-response ROAT preceded by a Diagnostic Patch Test (DPT). 79 patients with a known MCI/M allergy were contacted, 29 were diagnostically patch tested and 25 had their allergy confirmed. 25 MCI/M-allergic subjects and 10 healthy non-allergic control subjects were challenged with 2 ppm of MCI/MI/unit area of skin for 4 weeks. After a wash out period of at least 4 weeks the subjects were challenged with 7.5 ppm of MCI/MI/unit area of skin for 4 weeks. A ROAT with 2 drops of solution twice a day was conducted on the volar aspect of the left and right forearms on a 3 × 3 cm area resulting in dose/unit area of MCI/MI of 0.025 mg/cm2 and 0.095 mg/cm2 for 2 ppm and 7,5 ppm MCI/MI respectively. The elicitation capacity of MCI/MI in MCI/MI sensitive patients is dependent on the exposure dose/unit area and time The results of this study will be a useful addition to the risk assessment information available for MCI/MI. The risk assessment for the use of MCI/MI in rinse off consumer products is unaffected by the results of this study. [source]

ENSO history recorded in Agathis australis (kauri) tree rings.

Part A: kauri's potential as an ENSO proxy
Abstract Although many of the main characteristics of the El Niño-Southern Oscillation (ENSO) phenomenon have been established, uncertainties remain concerning its multidecadal- to millennial-scale evolution. Because of the shortness of the instrumental record, we need to resort to proxy-based reconstructions to investigate ENSO's history prior to the mid 19th century, but the available proxy data is limited in both time and space. Here we investigate the potential for ENSO reconstruction from the tree rings of Agathis australis (kauri). Kauri is a long-lived endemic New Zealand conifer and grows in an ENSO teleconnection region not previously represented in ENSO multi-proxy studies. A high quality 423 year kauri regional master chronology (AD 1580,2002) is constructed. Statistical analysis of the period AD 1876,2002 confirms previous findings that kauri tree rings carry a strong regional-scale climate signal and that ENSO is a significant contributor (predominantly via the western pole of the Southern Oscillation). Kauri carries a signal of both ENSO phases, but with a slight El Niño bias. Growth sensitivity is primarily registered through a five-season window, extending from March (prior to growth initiation in September) through to the following May, with strongest relationships across the middle three seasons (June,February). Relationships appear to be stationary. We conclude that kauri has sufficient ENSO event capture skill to make it a useful addition to future multi-proxy ENSO reconstruction efforts. It may also have potential for stand-alone reconstruction of multidecadal- to millennial-scale evolution of ENSO activity, especially ENSO robustness. Copyright © 2007 Royal Meteorological Society [source]

Use of the first rib for adult age estimation: a test of one method

H. Kurki
Abstract The human first rib is relatively easy to identify and is often preserved, in comparison with elements such as the fourth rib and pubic symphysis. Therefore it is potentially a valuable skeletal element for estimating age in forensic and archaeological contexts. A method of adult age estimation using the first rib (Kunos et al., 1999) is tested on a sample of known age skeletons from the J.C.B. Grant Collection (n,=,29, mean age,=,55.7 years). The high correlation coefficient (r,=,0.69) and moderate coefficient of determination (r2,=,0.47) demonstrate agreement between the known and estimated ages, suggesting that the first rib demonstates morphological changes with age. The inaccuracy and bias are high (all ages inaccuracy,=,10.4 years, bias,=,4.7 years) but comparable to several other age estimation methods in common use. Although the results are not as good for younger age categories (<,50 years: inaccuracy and bias rank ninth of nine age estimation methods), the inaccuracy and bias for the older age categories are relatively low (60,+ years inaccuracy,=,8.9 years, ranks third out of nine; bias,=,,,5.8 years, ranks first out of nine) compared with other age estimation methods. The first rib method is reasonably precise (93% of individuals fall within the limits of agreement of the mean difference between two trials). The first rib method is therefore a useful addition to the methods available for biological profile reconstructions from skeletal remains, especially if it is suspected that the remains represent an older individual. Copyright © 2005 John Wiley & Sons, Ltd. [source]

E-learning in the dermatological education at the Charité: evaluation of the last three years

Tilman Lüdert
Summary, Background: Numerous e-learning initiatives have been launched during the last decade. Many of them have not been continued, due to lack of acceptance on the part of the students, low quality or insufficient financial funding. Since 2002, the DEJAVU project has been integrated into the curriculum at the Department of Dermatology at Charité-Universitätsmedizin Berlin. DEJAVU offers an online archive of recorded lectures, lecture hand outs, structured learning modules, and case reports as well as online information about the courses/classes. Methods: Since beginning of the summer semester 2005, the student's acceptance and utilization of the online offerings was regularly surveyed, using anonymous questionnaires handed out together with the final exams. The teaching staff's opinions about e-learning were surveyed by means of a single anonymous questionnaire. Results: At the end of winter semester 2006/2007,93.5% of the students were aware of the existence of the e-learning program. The average amount of time spent with the program was 14.7 hours over the course of one semester. 66.8% of the students considered the program as very useful for their dermatology training. The lecture notes were the most frequently used online resource. Among the teaching staff, 86% considered e-learning a useful addition to traditional teaching. Conclusions: Our results show that e-learning is very well accepted by our students. It offers an additional way of acquiring knowledge and should be used to complement traditional ways of teaching. [source]

Rituximab as an adjunct to plasma exchange in TTP: A report of 12 cases and review of literature,

Sushama Jasti
Abstract Idiopathic thrombotic thrombocytopenic purpura (TTP) is caused by the production of autoantibodies against the Von Willebrand factor cleaving enzyme. This provides a rationale for the use of rituximab in this disease. We report a retrospective review of 12 patients treated with rituximab for TTP refractory to plasma exchange. Eleven patients were treated during initial presentation, and one patient was treated for recurrent relapse. Ten patients responded to treatment. Median time to response after first dose of rituximab was 10 days (5,32). Of the 11 patients treated during initial presentation, nine remain free of relapse after a median follow-up of 57+ months (1+,79+). Two patients died during initial treatment. One patient was lost to follow-up 1 month after achieving complete response. The patient treated for recurrent disease during second relapse remained disease free for 2years, relapsed and was treated again with rituximab, and was in remission for 22 months. She relapsed again, was retreated, and has now been in remission for 21+ months. We conclude that rituximab is an useful addition to plasma exchange treatment in TTP, but its exact role and dosing need to be verified in prospective studies. J. Clin. Apheresis, 2008. © 2008 Wiley-Liss, Inc. [source]

Carcinosarcoma of the vulva: A case report

Vera Loizzi
Abstract Carcinosarcoma is a well-recognized tumor even if it is an uncommon entity. Neoplasms usually occur in the oral cavity, pharynx, esophagus, larynx and skin, and have been rarely documented in the female genital tract. This case reports a patient with a diagnosis of vulvar carcinosarcoma that has been treated with radical vulvectomy and a left inguinal lymphadenectomy but she died two months later of progressive disease. Because of the extreme rarity and severe prognosis of the tumor, we believe that this is a useful addition to the literature and might serves as a reminder to physicians that a multidisciplinary approach for management should be undertaken for treatment. [source]

Clinical evaluation of a valveless non-absorber breathing system in spontaneously breathing canine patients

D. J. Holden
A valveless non-absorber breathing system novel to veterinary anaesthesia is described. The performance of this system was evaluated in 35 anaesthetised spontaneously breathing dogs weighing between 2,1 and 56 kg. Fresh gas flows were reduced incrementally until rebreathing (defined as an increase in end-Inspired carbon dioxide tension above 0.2 per cent) started to occur, as measured by capnography. A significant relationship (P<0.0001) between critical fresh gas flow and bodyweight was determined, and a mean critical fresh gas flow rate of 145 ±21 ml/kg/minute was derived for 15 dogs weighing 10 kg or less (mean 6.7 ±2.6 kg) and one of 98 ±16 ml/kg/minute for the remaining 20 dogs weighing 11 kg or greater (mean 30.2 ±13.9 kg). The fresh gas requirements for each group were found to differ significantly (P<0.0001), although the correlation between critical fresh gas flow and bodyweight was not Significant (P=0.054) in the dogs weighing 10 kg or less. It is suggested that the system may prove an economical and useful addition to the breathing systems currently used in canine anaesthesia. [source]

Communicating the value of probabilistic forecasts with weather roulette

Renate Hagedorn
Abstract In times of ever increasing financial constraints on public weather services it is of growing importance to communicate the value of their forecasts and products. While many diagnostic tools exist to evaluate forecast systems, intuitive diagnostics for communicating the skill of probabilistic forecasts are few. When the goal is communication with a non-expert audience it can be helpful to compare performance in more everyday terms than ,bits of information'. Ideally, of course, the method of presentation will be directly related to specific skill scores with known strengths and weaknesses. This paper introduces Weather Roulette, a conceptual framework for evaluating probabilistic predictions where skill is quantified using an effective daily interest rate; it is straightforward to deploy, comes with a simple storyline and importantly is comprehensible and plausible for a non-expert audience. Two variants of Weather Roulette are presented, one of which directly reflects proper local skill scores. Weather Roulette contrasts the performance of two forecasting systems, one of which may be climatology. Several examples of its application to ECMWF forecasts are discussed illustrating this new tool as useful addition to the suite of available probabilistic scoring metrics. Copyright © 2008 Royal Meteorological Society [source]

Tramadol for pain relief in children undergoing tonsillectomy: a comparison with morphine

Thomas Engelhardt MD
SummaryBackground: Pain control for paediatric patients undergoing tonsillectomy remains problematic. Tramadol is reported to be an effective analgesic and to have a side-effect profile similar to morphine, but is currently not licensed for paediatric use in the UK. Methods: We conducted a prospective, double-blind, randomized controlled trial in children who were scheduled for elective tonsillectomy or adenotonsillectomy at the Royal Aberdeen Children Hospital. Following local ethics committee approval and after obtaining a drug exemption certificate from the Medicines Licensing Agency for an unlicensed drug, we recruited 20 patients each into morphine (0.1 mg·kg,1), tramadol (1 mg·kg,1) and tramadol (2 mg·kg,1) groups. These drugs were given as a single injection following induction of anaesthesia. In addition, all patients received diclofenac (1 mg·kg,1) rectally. The postoperative pain scores, analgesic requirements, sedation scores, signs of respiratory depression and nausea and vomiting, as well as antiemetic requirements, were noted at 4-h intervals until discharge. Results: There were no statistically significant differences in age, weight, type of operation or induction of anaesthesia, 4-h sedation and pain scores and further analgesic requirements. There were no episodes of respiratory depression. Morphine was associated with a significantly higher incidence of vomiting following discharge to the wards (75% versus 40%, P=0.03) compared with both tramadol groups. Conclusions: Tramadol has similar analgesic properties, when compared with morphine. The various pharmaceutical presentations and the availability as a noncontrolled substance may make it a useful addition to paediatric anaesthesia if it becomes licensed for paediatric anaesthesia in the UK. [source]

Nasendoscopy: a useful addition to the anaesthetist's armamentarium

ANAESTHESIA, Issue 6 2000
I. R. Appadurai
First page of article [source]

Identification and significance of sources of spatial variation in grapevine water status

Abstract Background and Aims:, Water stress in grapevines is directly linked to grape quality. Differential vine water management should therefore be strongly linked to the water stress in the vine. To do this, an understanding of the dominant drivers and indicators of vine water status are needed from a sub-block to whole vineyard level. This understanding will help generate effective vine water status models for variable rate irrigation systems. Methods and Results:, A vineyard in the south of France was sampled for pre-dawn leaf water potential (,PD) at several dates during the growing season for two consecutive years. Sampling was stratified by soil types and relative within-block vegetative expression. A recursive partitioning analysis identified that cultivar had a dominant effect at low water stress, while vegetative expression and then soil unit effects became dominant as water restriction increased. Variance in ,PD was calculated at difference scales (plant, site, block and vineyard) and Smith's heterogeneity law was used to evaluate the scalar nature of ,PD variance. Spatial heterogeneity increased as the season and water restriction increased. Conclusion:, Variance in ,PD changed temporally through a season and the dominant drivers/indicators also changed. The opportunity to spatially manage water stress (irrigation) increased as water restriction increased. Significance of the Study:, Managing vine water stress helps optimise production and a ,PD model would be a useful addition to a viticulture decision support system. This study identified how the variance in ,PD evolved during a season and the best ancillary indicators of ,PD for spatial and temporal modelling. [source]

Mid- and high-ratio premix insulin analogues: potential treatment options for patients with type 2 diabetes in need of greater postprandial blood glucose control

J. S. Christiansen
Some patients with type 2 diabetes continue to have high postprandial blood glucose levels on twice-daily regimens of ,low-ratio' premix insulin formulations (up to 30% rapid-acting, with 70% protracted insulin). These patients require intensified insulin therapy, which can be provided by a twice- or thrice-daily regimen of mid-ratio (50% rapid-acting and 50% protaminated intermediate-acting insulin , human or analogue) or high-ratio (70% rapid-acting and 30% protaminated insulin , analogue only) premix insulin. Alternatively, a third daily injection of low-ratio premix insulin can be added to the regimen, with the option of incorporating one or more injections of mid- or high-ratio premix as required, and as an alternative to basal,bolus therapy. How these mid- and high-ratio formulations differ from the low-ratio premix insulins is reviewed here, with the aim of identifying the role of these formulations in diabetes management. Glucose clamp studies have shown that premix analogues give serum insulin levels proportional to their percentage of rapid-acting uncomplexed insulin: the higher the proportion, the greater the maximum level reached. Other pharmacokinetic parameters were not always significantly different between the mid- and high-ratio formulations. In clinical trials, postprandial plasma glucose and glycated haemoglobin A1c (HbA1c) levels were significantly reduced with thrice-daily mid- /high-ratio premix analogue when compared with twice-daily low-ratio biphasic human insulin (BHI) 30/70 or once-daily insulin glargine. Moreover, glycaemic control with mid-/high-ratio premix analogue was found to be similar to that with a basal,bolus therapy. Mid- and high-ratio premix regimens are generally well tolerated. The frequency of minor hypoglycaemia was reportedly higher with mid- /high-ratio premix analogues than with BHI 30, but nocturnal hypoglycaemia was less frequent. Although there is little evidence that clinical outcomes with mid-ratio premix analogues are different from those with high-ratio, they are useful additions to the low-ratio formulations for the management of diabetes, and addressing postprandial hyperglycaemia in particular. [source]

Sensitivity and specificity of immunohistochemical antibodies used to distinguish between benign and malignant pleural disease: a systematic review of published reports

J King
Aims:, A systematic review of published reports that have evaluated the ability of immunohistochemistry and argyrophil nucleolar organizing region (AgNOR) staining to distinguish between benign and malignant pleural disease. Methods:, Nineteen relevant papers published during the period 1979,2005 were identified. Individual results of immunohistochemistry for five diagnostic antibodies were extracted to calculate diagnostic sensitivity and specificity. Results from five of these studies that had evaluated proliferation markers or AgNOR staining techniques were also summarized. Results:, Most antibodies demonstrated poor to moderate diagnostic ability. Desmin and epithelial membrane antigen (EMA) were the most useful, with sensitivity and specificity both above 74%. The combination of EMA and AgNOR was reported as having 95% diagnostic sensitivity. A high MCM2 labelling index also differentiated between benign and malignant pleural disease. Conclusions:, Immunohistochemistry is of limited value, but newer diagnostic methods may be useful additions in this area of pathology. The diagnostic importance of histological features seen on plain tissue sections is emphasized as vital for correctly differentiating between benign pleural disease and malignant pleural mesothelioma. [source]

Pharmacological Mechanisms of Naltrexone and Acamprosate in the Prevention of Relapse in Alcohol Dependence

John Littleton M.B.B.S., Ph.D.
Naltrexone and acamprosate may ultimately prove to be useful additions to pharmacotherapy for alcoholism by reducing relapse. Naltrexone is a relatively selective competitive antagonist at mu-opioid receptors, and this activity may explain its anti-relapse action either because endogenous opioids are involved in the positively reinforcing effects of alcohol and/or because these same transmitters are involved in the conditioned anticipation of these effects. In contrast, the pharmacology of acamprosate is still poorly understood. This is not surprising because it is a small flexible molecule with similarities to several neuro-active amino acids and is used in high doses. All these factors suggest that it may have multiple actions. Currently, the best explanation for the effects of acamprosate seems to be that it inhibits the glutamatergic transmitter system involved in both the negative reinforcing effects of alcohol and the conditioned "pseudo-withdrawal" that may be important in cue-induced relapse. [source]