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Common Cause (common + cause)
Selected AbstractsIdentifying Common Causes of UK and French Riots Occurring Since the 1980sTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 3 2009DAVID WADDINGTON Abstract: This article constitutes a response to the article by Fabien Jobard (in this issue) concerning the recent riots in France. It explores differences and commonalities between the events in France in 2005 and the urban disorders that occurred in England and Wales from the 1980s to 2001, placing the latter into three distinct categorical and temporal waves. Initially, it revisits the essence of Jobard's piece before providing an overview of the UK riots. It then analyses the overarching contexts of each of the three periods, and those of the French riots, as a basis for identifying the main causal similarities. [source] Botulinum Toxin Type-A (BOTOX®) in the Treatment of Occipital Neuralgia: A Pilot StudyHEADACHE, Issue 10 2008Martin Taylor DO Objective., To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A (BTX-A) in providing significant and prolonged pain relief in chronic occipital neuralgia. Background., Occipital neuralgia is a unilateral or bilateral radiating pain with paresthesias commonly manifesting as paroxysmal episodes and involving the occipital and parietal regions. Common causes of occipital neuralgia include irritation or injury to the divisions of the occipital nerve, myofascial spasm, and focal entrapment of the occipital nerve. Treatment options include medication therapy, occipital nerve blocks, and surgical techniques. BTX-A, which has shown promise in relief of other headache types, may prove a viable therapeutic option for occipital neuralgia pain. Methods., Botulinum toxin type-A (reconstituted in 3 cc of saline) was injected into regions traversed by the greater and lesser occipital nerve in 6 subjects diagnosed with occipital neuralgia. Subjects were instructed to report their daily pain level (on a visual analog pain scale), their ability to perform daily activities (on several quality of life instruments) and their daily pain medication usage (based on a self-reported log), 2 weeks prior to the injection therapy and 12 weeks following injection therapy. Data were analyzed for significant variation from baseline values. Results., The dull/aching and pin/needles types of pain reported by the subjects did not show a statistically significant improvement during the trial period. The sharp/shooting type of pain, however, showed improvement during most of the trial period except weeks 3-4 and 5-6. The quality of life measures exhibited some improvement. The headache-specific quality of life measure showed significant improvement by 6 weeks which continued through week 12. The general health- and depression-related measures showed no statistical improvement. No significant reduction in pain medication usage was demonstrated. Conclusions., Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia. Additionally, the quality of life measures assessing burden and long-term impact of the headaches, further corroborated improvement seen in daily head pain. [source] Fetal arrhythmia: Prenatal diagnosis and perinatal managementJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2009Yasuki Maeno Abstract The importance of managing fetal arrhythmia has increased over the past three decades. Although most fetal arrhythmias are benign, some types cause fetal hydrops and can lead to fetal death. With the aim of improving the outcome in such cases, various studies for prenatal diagnosis and perinatal management have been published. Detailed analysis of the type of arrhythmia in utero is possible using M-mode and Doppler echocardiography. In particular, a simultaneous record of Doppler waveform at the superior venous cava and the ascending aorta has become an important and useful method of assessing the interval between atrial and ventricular contractions. Common causes of fetal tachycardia (ventricular heart rate faster than 180 bpm), are paroxysmal supraventricular tachycardia (SVT) with 1:1 atrioventricular (AV) relation and atrial flutter with 2:1 AV relation. Of fetal SVT, short ventriculo-atrial (VA) interval tachycardia due to atrioventricular reentrant tachycardia is more common than long VA interval. Most fetuses with tachycardia are successfully treated in utero by transplacental administration of antiarrhythmic drugs. Digoxin is widely accepted as a first-line antiarrhythmic drug. Sotalol, flecainide and amiodarone are used as second-line drugs when digoxin fails to achieve conversion to sinus rhythm. Fetal bradycardia is diagnosed when the fetal ventricular heart rate is slower than 100 bpm, mainly due to AV block. Approximately half of all cases are caused by associated congenital heart disease, and the remaining cases that have normal cardiac structure are often caused by maternal SS-A antibody. The efficacy of prenatal treatment for fetal AV block is limited compared with treatment for fetal tachycardia. Beta stimulants and steroids have been reported as effective transplacental treatments for fetal AV block. Perinatal management based on prospective clinical study protocol rather than individual experience is crucial for further improvement of outcome in fetuses with tachycardia and bradycardia. [source] Hematological predictors of increased severe anemia in Kenyan children coinfected with Plasmodium falciparum and HIV-1,AMERICAN JOURNAL OF HEMATOLOGY, Issue 4 2010Gregory C. Davenport Malaria and HIV-1 are coendemic in many developing countries, with anemia being the most common pediatric hematological manifestation of each disease. Anemia is also one of the primary causes of mortality in children monoinfected with either malaria or HIV-1. Although our previous results showed HIV-1(+) children with acute Plasmodium falciparum malaria [Pf(+)] have more profound anemia, potential causes of severe anemia in coinfected children remain unknown. As such, children with P. falciparum malaria (aged 3,36 months, n = 542) from a holoendemic malaria transmission area of western Kenya were stratified into three groups: HIV-1 negative [HIV-1(,)/Pf(+)]; HIV-1 exposed [HIV-1(exp)/Pf(+)]; and HIV-1 infected [HIV-1(+)/Pf(+)]. Comprehensive clinical, parasitological, and hematological measures were determined upon enrollment. Univariate, correlational, and hierarchical regression analyses were used to determine differences among the groups and to define predictors of worsening anemia. HIV-1(+)/Pf(+) children had significantly more malarial pigment-containing neutrophils (PCN), monocytosis, increased severe anemia (Hb < 6.0 g/dL), and nearly 10-fold greater mortality within 3 months of enrollment. Common causes of anemia in malaria-infected children, such as increased parasitemia or reduced erythropoiesis, did not account for worsening anemia in the HIV-1(+)/Pf(+) group nor did carriage of sickle cell trait or G6PD deficiency. Hierarchical multiple regression analysis revealed that more profound anemia was associated with elevated PCM, younger age, and increasing HIV-1 status ([HIV-1(,) , HIV-1(exp) , HIV-1(+)]. Thus, malaria/HIV-1 coinfection is characterized by more profound anemia and increased mortality, with acquisition of monocytic pigment having the most detrimental impact on Hb levels. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc. [source] Restless legs syndrome: an early manifestation of Huntington's disease?ACTA NEUROLOGICA SCANDINAVICA, Issue 4 2009E. Savva Background,,, Far from being uniform, Huntington's disease (HD)'s phenotype encompasses a large variety of motor and non-motor symptoms which occur in various combinations in individual patients. Aim,,, To describe an unusual association between restless legs syndrome (RLS) and HD. Methods and results,,, We report a patient with an atypical presentation of genetically demonstrated HD, who developed typical RLS a few years prior to and during the course of HD. Common causes of RLS were excluded and the polysomnography confirmed frequent and severe periodic limb movements during sleep and while awake. Conclusions,,, We propose RLS as an uncommon but early feature of HD in some patients, and suggest adding HD to the already long list of RLS secondary to neurodegenerative conditions. [source] Epilepsy in South AfricaACTA NEUROLOGICA SCANDINAVICA, Issue 2005R. Eastman Since its first democratic elections in 1994, South Africa has undertaken a massive social reconstruction program that has included major healthcare reform. The state healthcare system aims to provide a unitary service, based on a primary healthcare approach, to the 85% of the population who depend on it. Although the burden of epilepsy is largely unknown, it is likely to be large, with a study of children in a large rural community, for example, demonstrating an active prevalence of 6.7/1000. Common causes of epilepsy are likely to include infectious diseases, such as neurocysticercosis and HIV/AIDS, trauma and alcohol consumption. Limited evidence suggests the existence of a large treatment gap in some areas. The management and treatment of epilepsy are also greatly influenced by cultural attitudes and beliefs, which vary widely. South Africa thus provides a microcosm of issues affecting the management of epilepsy worldwide. [source] Prevention of pneumococcal disease in children.ACTA PAEDIATRICA, Issue 5 2001Pneumococcal conjugate vaccines: their use globally could have a major impact on public health Pneumococcal disease is a major cause of morbidity and mortality in infants and young children worldwide. New pneumococcal conjugate vaccines include 7 to 11 serotypes, which are the most common cause of paediatric disease in most parts of the world. The efficacy of a 7-valent conjugate vaccine was 97.4% (95% CI, 82.7,99.9) against invasive pneumococcal disease, and 57% (95% CI, 44,67) against otitis media, caused by vaccine serotypes. Evidence shows that the vaccine has the potential to prevent pneumonia. Pneumococcal conjugate vaccination has also been shown to reduce nasopharyngeal carriage of vaccine serotypes (particularly serotypes associated with antibiotic resistance). Thus widespread use of pneumococcal conjugate vaccine could substantially reduce the burden of invasive disease and would have the potential to control the global spread of antibiotic resistance in pneumococci. Conclusion: It is important that these highly effective vaccines should be made available to children in the developing countries. [source] Clinical aspects on neonatal cholestasis based on observations at a Swedish tertiary referral centreACTA PAEDIATRICA, Issue 2 2001B Fischler The aim of the study was to investigate the clinical aspects of neonatal cholestasis. The medical records of 85 cholestatic infants were retrospectively reviewed. A majority of the patients were referred from other parts of the country. The most common diagnoses were extrahepatic biliary atresia (n= 30 patients), ,1 -antitrypsin deficiency (n=11) and progressive familial intrahepatic cholestasis (n= 11). On presentation, the biliary atresia group had higher mean serum values of bilirubin, G-GT and cholesterol than the patients with intrahepatic cholestasis, with no significant differences noticed for any other biochemical parameter. A lack of excretion on hepatobiliary scintigraphy was noticed in all investigated patients with biliary atresia, but also in 9 of 34 patients with intrahepatic neonatal cholestasis. There was no statistical correlation between the age at portoenterostomy and the outcome in patients with biliary atresia. However, both the detection of a partial flow on perioperative cholangiogram and the establishment of a non-icteric phase within 6 mo after the portoenterostomy correlated to a good outcome. Eight of 11 patients with progressive familial intrahepatic cholestasis were treated with a biliary diversion procedure, five of eight experienced a sustained cholestatic remission. Conclusions: Progressive familial intrahepatic cholestasis may be a more common cause of neonatal cholestasis in Sweden than reported elsewhere and that the experience with biliary diversion is positive. While early referral in patients with extrahepatic biliary atresia remains important, a portoenterostomy should be attempted also in patients referred after 3 mo of age. [source] Practical Assessment of Maternal Cardiovascular Risk in PregnancyCONGENITAL HEART DISEASE, Issue 5 2008Nazanin Moghbeli MD ABSTRACT Cardiovascular disease in pregnancy is the most common cause of maternal mortality in the developed world and an important cause of heart failure, stroke, and arrhythmia. As more children with congenital heart disease survive into adulthood, there is a more pressing need to understand the risks that pregnancy poses for these women. Pregnancy, labor, and delivery increase the hemodynamic stress on the cardiovascular system and place women with heart disease at increased risk of cardiovascular complications, which include heart failure and death. Systematic assessment of pregnancy risk in these women, ideally before conception, is essential in optimizing maternal and fetal outcomes. This article describes the process of assessing risk of pregnancy-associated cardiovascular complications in women with structural heart disease. We review the current literature on pregnancy risk in women with complex congenital lesions, valvular heart disease, cardiomyopathy, and aortopathy, and suggest an approach to risk stratification. Based on a review of the literature, we report features that pose an increased risk of adverse maternal and fetal outcomes, which include poor maternal functional status; prior history of heart failure, arrhythmia, or cerebral vascular events; cyanosis; poor systemic ventricular function; and severe aortic or mitral stenosis. Pulmonary hypertension and Eisenmenger syndrome place women at exceedingly high risk for cardiovascular complications in pregnancy, including maternal and fetal death. [source] Fragrance contact allergic patients: strategies for use of cosmetic products and perceived impact on life situationCONTACT DERMATITIS, Issue 6 2009Susan Hovmand Lysdal Background: Fragrance ingredients are a common cause of contact allergy. Very little is known about these patients' strategies to manage their disease and the effect on their daily lives. Objectives: To investigate if patients with diagnosed fragrance contact allergy used scented products, how they identified tolerated products, and if fragrance allergy affected their daily living. Method: One hundred and forty-seven patients diagnosed with fragrance contact allergy in a 20-month period were included and received a postal questionnaire concerning the subjects of the study. One hundred and seventeen (79.6%) replied. Results: In total, 53/117 (45.3%) responded that they had found some scented products that they could tolerate. Thirty-seven (31.6%) had not tried to find any scented products and 26 (22%) had tried but could not find any. The methods most often used were trying different products and reading the ingredient label. Of the total respondents, 17.1% reported sick-leave due to fragrance allergy and 45.3% found that fragrance allergy significantly affected their daily living. Conclusion: Many patients with fragrance contact allergy succeeded in finding some scented products, which they could tolerate, e.g. by use of ingredient labelling, but a significant proportion had continued skin problems. Almost half of the patients perceived that fragrance allergy significantly affected their daily lives. [source] Intermittent exposure to low-concentration paraphenylenediamine can be equivalent to single, higher-dose exposureCONTACT DERMATITIS, Issue 5 2007Jonathan M. L. White Hair dye allergy is an important and increasingly common cause of allergic contact dermatitis. The role of repeated exposure in elicitation of allergy has not previously been extensively studied. We have therefore compared elicitation between single and intermittent exposure to paraphenylenediamine (PPD). 23 subjects known to be allergic to PPD from positive patch tests were exposed to 0.3% and 0.03% PPD, both in petrolatum and water, for 5 min at the same site every day for up to 8 D. In the same subjects, single exposures were also performed at different sites, from 5 to 40 min. Other experiments exposed rat skin to radiolabelled PPD as one-off application or multiple exposures. There were 8 reactions in the cumulative exposure site using 0.3% PPD in aqueous solution. In 7 of these, there was an exact correlation with reaction to the cumulative time needed for repeat exposures to elicit a reaction and the time needed for a reaction to the single exposure. There were no reactions to 0.03% PPD in water or pet under either type of exposure condition. There was also a positive correlation between grade of original reaction in clinic (+++, ++, +) and appearance/intensity of elicitation reactions. In the animal study, cumulative time and single exposure time sites correlated with regards to retention of radiolabelled substance within the skin. This study therefore demonstrates for the first time that, over the time period tested, the allergenic component of PPD accumulates in the skin. Hence, intermittent exposure to lower concentrations of PPD may be equivalent to higher concentration, one-off exposure. [source] Indirect evidence for increased mechanosensitivity of jejunal secretomotor neurones in patients with idiopathic bile acid malabsorptionACTA PHYSIOLOGICA, Issue 2 2009A. Bajor Abstract Aim:, The interdigestive motor rhythm, the migrating motor complex (MMC), is accompanied by active secretion of chloride during periods of distally propagating maximal motor activity (MMC phase III). We studied the behaviour of this system in bile acid malabsorption (BAM), a relative common cause of chronic diarrhoea. We measured motor activity and transmucosal potential difference (PD, reflecting active chloride secretion), in the proximal jejunum in healthy controls (n = 18) and in a group of patients with BAM (n = 11). The phase III-generated voltage was related to the degree of BAM quantified by the 75SeHCAT test. Methods:, We used a multi-channel intestinal infusion system to simultaneously measure jejunal pressure and PD. Saline passing calomel half-cells was infused into the jejunum and subcutaneously. Pressure and PD were recorded in the fasting state and after a test meal. Results:, In the absence of motor activity, jejunal PD was not significantly different from zero in either group. During MMC phase III, PD reached significantly higher mean and peak levels in BAM patients. The product of MMC phase III length multiplied by voltage, over 3 h, was also significantly higher in BAM patients (controls: median 307 mV × cm, range 70,398; BAM: median 511, range 274,2271, P < 0.01). This value was also significantly correlated with the degree of BAM as reflected by the 75SeHCAT test (P < 0.05). Conclusion:, Phase III induced jejunal secretion may be upregulated in BAM patients, resulting in overload of colonic reabsorption capacity. [source] Traumatic injuries to permanent teeth in Turkish children, AnkaraDENTAL TRAUMATOLOGY, Issue 3 2009Ceyhan Altun From a total of 4956 children aged 6,12 years (mean age: 8.91 ± 1.95) applying to the Center, 472 children (9.5%) were found to have suffered dental injuries during a period of 2 years. Injuries were classified according to drawings and texts based on the WHO classification system, as modified by Andreasen and Andreasen. Injury rates were highest among children age 6 and ages 8,10. The most frequently injured permanent teeth were the maxillary central incisors (88.2%), and the maxillary right central permanent incisor made up 47.2% of all injured teeth. The most common cause of dental trauma was falling while walking or running (40.3%). Most injuries involved a single tooth (64.8%). The most common type of injury was enamel fracture (44.6%). There was a significant difference in gender, where boys more often suffered from a dental hard tissue and pulp injury than girls (P = 0.019), whereas there was no difference in gender (P = 0.248) in the distribution of periodontal injuries. Injuries were found to occur more frequently during the summer (P < 0.001). Children with increased overjet were 2.19 times more likely to have dental injuries than other children. Considering that the incidence of traumatic dental injury is highest among children ages 6 and ages 8,10 as well as the fact that patients with increased overjet are more prone to dental trauma, preventive orthodontic treatment in early mixed dentition may play an important role in reducing traumatic dental injuries. [source] Prevalence and causes of fractured permanent incisors in 12-year-old suburban Nigerian schoolchildrenDENTAL TRAUMATOLOGY, Issue 3 2009Comfort A. Adekoya-Sofowora A dental trauma cross-sectional survey was carried out through clinical examination of upper and lower permanent incisors and interviews with 415 (212 boys, 203 girls) 12-year-old children attending private and public secondary schools in lle-Ife, in 2004/2005 by one calibrated examiner. Garcia-Godoy's classification was used. The prevalence of traumatic dental injuries was 12.8%. There was no statistical difference in the prevalence between boys and girls P > 0.05. The most common cause of injuries was falls (49.1%), followed by traffic accidents (13.2%), collision against objects or people (11.3%) and misuse of teeth 9.4%. The commonest type of injury was enamel fracture alone (9.9%), followed by enamel-dentine fracture (4.8%). Majority of the accidents occurred at home (60.4%), followed by school (26.4%). The prevalence of traumatic dental injuries was on the increase among suburban Nigerian children in Ile-Ife and it has a potential to be considered an emerging public health problem. [source] The prevalence of traumatic injuries treated in the pedodontic clinic of Ankara University, Turkey, during 18 monthsDENTAL TRAUMATOLOGY, Issue 6 2002Abstract , , ,The purpose of this study was to evaluate the type and prevalence of dental injuries referred to Ankara University, School of Dentistry, Department of Pedodontics, Turkey. One hundred and forty-seven patients with 234 traumatized teeth presented during 18-month interval. Of the 147 patients, 85 were boys and 62 were girls. The most frequent trauma occurred in the age of 11 years. The maxillary central incisors were found to be the most affected tooth in both primary and permanent dentition injuries. The maxillary arch is involved in a higher percentage of trauma cases (95.72%). The most common cause of injuries are falls (67.34%). In the primary dentition, the most common type of injury is extrusive luxation (38.23%) and in the permanent dentition, it is fracture of enamel,dentin without pulpal involvement (50.5%). From 147 patients, only 82 presented to our clinic within 1 h and 10 days after the injury time. It reveals that there is a need to inform the public of what they should do in cases of dental trauma, and how important it is to contact a dentist immediately. [source] Dental emergencies presenting to a dental teaching hospital due to complications from traumatic dental injuriesDENTAL TRAUMATOLOGY, Issue 4 2002Suhad H. Al-JundiArticle first published online: 29 JUL 200 Abstract ,,,In Jordan, only two surveys of dental trauma have been carried out. The aim of this study was to determine the incidence and pattern of dental emergencies resulting from traumatic injuries, as well as treatment provided to children presenting with these dental emergencies. Over a 1-year period, 620 children presented to our pediatric dental clinics with dental emergencies; 195 (31%) of these emergencies were a consequence of dental trauma to 287 teeth and were included in the study. The average time between the trauma and the dental emergency was 5 months. Pain or sensitivity was the most frequent presenting symptom (31.3%) followed by swelling or sinus tract (17.4%). The age of these patients ranged from 15 months to 14 years, with an average age of 9.3 years. Males accounted for 75.4% of the children in the samples, whereas females accounted for only 24.6%. The main cause of dental trauma was falling during play (58.5%); the least common cause was motor vehicle accidents, accounting for only 1.5% of all injuries. Most of the dental injuries occurred at home (41.5%), around noon time. The most commonly involved teeth were permanent maxillary central incisors accounting for 79.5% of all teeth involved by dental trauma. The most frequently encountered type of trauma in this sample was crown fracture seen in 76.6% of the teeth . Soft tissue injuries were estimated to occur in 16.9% of the children. The treatment received by the children in the sample ranged from no active treatment (6.2%) to elaborate dental procedures such as pulp therapy (41.3%) and prosthetic replacement of missing teeth (5.1%). [source] Congenital CMV infection: a common cause of childhood disabilityDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2008Vlatka Meja, ki-Bo No abstract is available for this article. [source] Long-term outcome of children with cortical visual impairmentDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2006Carey A Matsuba MDCM MHSc FRCP(C) Cortical visual impairment (CVI) is now the most common cause of visual impairment in children. Little is known about the long-term visual outcome. This study evaluates the outcome of children with congenital CVI. Using medical records, 423 children (225 males, 198 females) were identified with congenital CVI. Of these children, 259 had follow-up visual acuity assessments. The children's gestational age varied with 32 weeks or less representing 15.9%; 33 to 36 weeks representing 10.7%; 37 to 42 weeks representing 61.2%; and 43 weeks or greater representing 0.9% (11.3% of patients'gestational age was unrecorded). Clinical data were extracted and information regarding outcome was gathered. The majority of children showed improvement in their visual acuity levels after 2 or more years of follow-up. For the 194 children initially assessed before 3 years of age, 97 had improved, 75 were unchanged, 18 had deteriorated, and 4 had sub-optimal assessments. For the 74 children initially assessed at 3 or more years of age, 23 had improved, 44 remained unchanged, 3 had deteriorated, and 4 had sub-optimal testing. Children with better visual acuity levels at follow-up were more likely to have favourable cognitive outcomes (non-mental retardation)* in 12.2% versus 2.8% (p<0.01). Similarly, favourable motor outcomes (independent ambulation) were present in 20.1% for those with better visual acuities versus 7.9% for those with poorer visual acuities (p<0.01). Our study demonstrates that the majority of children with CVI underwent improvement in visual acuity. Additional disabilities were common, but those children with better visual acuity outcomes faired better. Given the frequency of comorbid conditions, appropriate diagnostic assessment services are needed. [source] Current treatment of non-alcoholic fatty liver diseaseDIABETES OBESITY & METABOLISM, Issue 3 2009Mohamed H. Ahmed Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in Western World and frequently associated with insulin resistance and overweight and occurs often with type 2 diabetes. Interestingly, NAFLD is not only regarded as a hepatic component of the metabolic syndrome but also as an independent risk factor and a marker for increase in cardiovascular disease (CVD). Significantly, NAFLD is associated with an increased risk of all-cause mortality and predicts future CVD events independent of age, sex, LDL-cholesterol and features of metabolic syndrome. Although there was initial concern about drug toxicity with NAFLD, increasing evidence suggests that commonly used drugs such as metformin and statins do not cause harm and the thiazolidinediones (TZDs) may even confer a therapeutic benefit in NAFLD. Interestingly, medical and surgical treatments of obesity show potential benefit in treating NAFLD. In this review, we have focused on the safety and therapeutic impact of TZDs, statins, metformins and obesity medications in NAFLD. The potential benefit of bariatric surgery and the role of weight loss per se in treating NAFLD are also discussed. [source] The role of angiotensin II type 1 receptor blockers in the prevention and management of diabetes mellitusDIABETES OBESITY & METABOLISM, Issue 5 2007G. Mathur Angiotensin II Receptor blockers (ARBs) are an important addition to the current range of medications available for treating a wide spectrum of diseases including cardiovascular diseases. Coronary heart disease (CHD) is the most common cause of death in the United Kingdom and worldwide. More importantly, the presence of the metabolic syndrome and the likelihood of diabetes mellitus taking on epidemic proportions in the years to come all threaten to maintain the mortality rate due to CHD. This review article focuses on the clinical studies that have helped define the trends in the usage of these agents in the prevention and treatment of diabetes mellitus and its complications and also explores possible mechanisms of action and future developments. [source] Theology is not Mere Sociology: A Theological Reflection on the Reception of the Christian Religion in Mainland ChinaDIALOG, Issue 3 2004By Pilgrim W.K. Abstract:, Post-Maoist China retains its loyalty to Marxist principles; yet voices are being heard that interpret religion much more positively. Both government spokespersons and Religious Studies scholars measure the value of religion according to its social function. Such a criterion of evaluation fails to take account of what is essential to Christian theology, namely, appeal to divine transcendence. Yet, Christian theology in the tradition of the Lutheran Reformation begins with transcendence and turns toward human responsibility for the world through loving the neighbor. This may mark a common cause between Chinese sociology of religion and Christian commitments to social well-being. [source] Translational medicine perspective in development of disease modifying therapies for Alzheimer's disease: biomarkers to buy down the riskDRUG DEVELOPMENT RESEARCH, Issue 2 2009Hong I. Wan Abstract Alzheimer's disease (AD) is a progressive neurodegenerative disease and the most common cause of age-related dementia. Currently available pharmacologic therapies, including acetylcholinesterase (AChE) inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists, only treat symptoms and do not address the underlying neurodegeneration. In addition to potentially improve the accuracy of diagnosis, biomarkers serve important roles for the development of putative disease-modifying drugs for AD. In this article, we review the existing and emerging areas of biomarker research and development for AD. Biochemical biomarkers in cerebrospinal fluid have been used to provide a link to disease pathology and may provide important proof of concept data for several classes of emerging therapeutics. Imaging biomarkers including volumetric magnetic resonance imaging and positron emission tomography assessing either glucose utilization or radioligands binding to amyloid plaque are discussed. Appropriate uses of these biomarkers in the context of the development of disease-modifying therapies are discussed. Drug Dev Res 70, 2009. © 2009 Wiley-Liss, Inc. [source] Cytosolic protein-protein interactions that regulate the amyloid precursor proteinDRUG DEVELOPMENT RESEARCH, Issue 2 2002Shasta L. Sabo Abstract Alzheimer disease (AD), a progressive neurodegenerative disease, is the most common cause of dementia in the elderly and is among the leading causes of death in adults. AD is characterized by two major pathological hallmarks, amyloid plaques and neurofibrillary tangles. For a number of reasons, amyloid plaque accumulation is widely thought to be the probable cause of AD. The amyloid plaque core is largely composed of an approximately 4-kDa peptide referred to as A,. A, is derived from its precursor, the Alzheimer amyloid protein precursor (APP), by endoproteolytic processing. APP is a type I integral membrane protein, with a long extracellular domain, one transmembrane domain, and a short (,50 amino acid) cytoplasmic tail. Despite intense efforts to decipher the function of APP, its normal physiological role has remained elusive. The carboxy-terminus of APP contains the sequence YENPTY, which is absolutely conserved across APP homologues and across species. The YENPTY sequence is important for regulation of APP processing and trafficking. Given the importance of the cytoplasmic domain in APP physiology, a number of laboratories have hypothesized that proteins that bind to the YENPTY sequence in the cytoplasmic domain of APP might regulate APP processing, trafficking, and/or function. In this article, we will discuss data revealing which proteins bind to the cytoplasmic domain of APP, how these binding-proteins regulate APP metabolism and function, and why such protein-protein interactions provide an exciting new target for therapeutic intervention in AD. Drug Dev. Res. 56:228,241, 2002. © 2002 Wiley-Liss, Inc. [source] "My Two-week-old Daughter Is Throwing up Blood"ACADEMIC EMERGENCY MEDICINE, Issue 8 2005M.H. Moustafa MD Abstract Swallowed maternal blood at the time of delivery or from cracked nipples during breastfeeding is the most common cause of suspected gastrointestinal bleeding in the neonate. In this case, the Apt,Downey test is a useful diagnostic tool. The Apt,Downey test can effectively differentiate neonatal from maternal hemoglobin based on the conversion of oxyhemoglobin to alkaline globin hematin when mixed with alkali. [source] Role of Contrast Echocardiography in the Assessment of Myocardial RuptureECHOCARDIOGRAPHY, Issue 1 2003Sumit Mittle M.D. Left ventricular free wall rupture is known to complicate acute myocardial infarction and is the second most common cause of inhospital mortality in this patient population. Contrary to widely held medical belief, this does not always result in immediate fatal pericardial tamponade with hemodynamic collapse. Up to 40% of such occurrences are subacute and may evolve over hours or even days. A high index of suspicion and accurate diagnostic tests are required to identify and treat these patients with emergent surgery. Echocardiography has emerged as an important diagnostic modality to identify this catastrophic condition. Although the literature has scattered reports on the role of transesophageal and transthoracic echocardiography in diagnosing free wall rupture, to date, only one report in the literature used ultrasound contrast agents to better delineate echocardiographic findings. We will present two cases in which echocardiography with use of intravenous ultrasound contrast agents was instrumental in helping to exclude rupture in one case and help identify rupture in another. (ECHOCARDIOGRAPHY, Volume 20, January 2003) [source] Unemployment, growth and taxation in industrial countriesECONOMIC POLICY, Issue 30 2000Francesco Daveri To the layman, the upward trend in European unemployment is related to the slowdown of economic growth. We argue that the layman's view is correct. The increase in European unemployment and the slowdown in economic growth are related, because they stem from a common cause: an excessively rapid growth in the cost of labour. In Europe, labour costs have gone up for many reasons, but one is particularly easy to identify: higher taxes on labour. If wages are set by strong and decentralized trade unions, an increase in labour taxes is shifted onto higher real wages. This has two effects. First, it reduces labour demand, and thus creates unemployment. Secondly, as firms substitute capital for labour, the marginal product of capital falls; over long periods of time, this in turn diminishes the incentive to invest and to grow. The data strongly support this view. According to our estimates, the observed rise of 14 percentage points in labour tax rates between 1965 and 1995 in the EU could account for a rise in EU unemployment of roughly 4 percentage points, a reduction of the investment share of output of about 3 percentage points, and a growth slowdown of about 0.4 percentage points a year. [source] Experience in adverse events detection in an emergency department: Nature of eventsEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2007James Hendrie Abstract Objective:, The study was performed to determine the nature of adverse events in an ED. Methods:, The methodology has been described in the accompanying paper. Two by two tables were analysed using the two-tailed Fisher's exact test. A P -value of ,0.05 was considered significant. Statistical analysis was performed using MINITAB. Results:, One hundred and ninety-four events were detected, from a sample of 3222 patients. Except where specified, events with management causation ,3 were excluded. This excluded 24 events (12.4%) leaving 170 for analysis. Errors of commission occurred in 55% and omission in 45%. Errors of commission were significantly associated with prior events, errors of omission with ED events (P , 0.0001, respectively). The most common cause of events was drug reactions. 1.35% had a Naranjo score , 1, 0.54% , 4. Prior events were significantly associated with adverse drug reactions (P , 0.0001). Drug reactions were associated with a lower preventability score (P , 0.0001). Diagnostic issues were present in 1.2%. All three categories, that is diagnosis not considered, diagnosis within the differential and seriousness not appreciated were associated preventability ,4 (P , 0.0001, P , 0.02 and P , 0.004, respectively). Diagnostic problems were significantly associated with ED events (P , 0.0001). Conclusion:, In conclusion, the data demonstrate that events fall into two sets: prior events which are associated with errors of commission, drug reactions and lower preventability; and ED events which are associated with errors of omission, diagnostic issues and high preventability. [source] The Epidemiology of Convulsive Status Epilepticus in Children: A Critical ReviewEPILEPSIA, Issue 9 2007Miquel Raspall-Chaure Summary:, There is ongoing debate regarding the most appropriate definition of status epilepticus. This depends upon the research question being asked. Based on the most widely used "30 min definition," the incidence of childhood convulsive status epilepticus (CSE) in developed countries is approximately 20/100,000/year, but will vary depending, among others, on socioeconomic and ethnic characteristics of the population. Age is a main determinant of the epidemiology of CSE and, even within the pediatric population there are substantial differences between older and younger children in terms of incidence, etiology, and frequency of prior neurological abnormalities or prior seizures. Overall, incidence is highest during the first year of life, febrile CSE is the single most common cause, around 40% of children will have previous neurological abnormalities and less than 15% will have a prior history of epilepsy. Outcome is mainly a function of etiology. However, the causative role of CSE itself on mesial temporal sclerosis and subsequent epilepsy or the influence of age, duration, or treatment on outcome of CSE remains largely unknown. Future studies should aim at clarifying these issues and identifying specific ethnic, genetic, or socioeconomic factors associated with CSE to pinpoint potential targets for its primary and secondary prevention. [source] Hippocampal Malformations Do Not Necessarily Evolve into Hippocampal SclerosisEPILEPSIA, Issue 6 2005Arjune Sen Summary:,Purpose: Hippocampal malformations have been proposed to underlie or evolve into hippocampal sclerosis, a common cause of refractory partial epilepsy. We report two patients with chronic epilepsy and developmental abnormalities of the hippocampus and cortex. We seek to address, in patients with recurrent convulsive seizures over many decades, whether hippocampal malformations necessarily progress to hippocampal sclerosis. Methods: The first patient died at age 76 years and had experienced convulsive seizures for 43 years. The second patient, aged 64 years at death, had experienced convulsive seizures for 49 years. The brains were processed routinely. Immunohistochemistry for dynorphin and neuropeptide Y was performed. Results: The first case exhibited bilateral perisylvian polymicrogyria. Both hippocampi demonstrated abnormal convolution in the CA1 subfield and subiculum. In the second case, periventricular heterotopia was found in the wall of the right lateral ventricle. The right hippocampus was abnormally oriented with excessive convolutions of the pyramidal cell layer between CA1 and the subiculum. In neither patient did the hippocampi exhibit neuronal loss. Furthermore, dynorphin immunohistochemistry revealed no reactivity in the molecular layers, and staining with neuropeptide Y confirmed normal numbers of hilar interneurons. Conclusions: These two cases demonstrate histologically that, even in long-standing epilepsy, malformations of the hippocampus do not necessarily develop into hippocampal sclerosis. [source] Cyclosporine Induces Epileptiform Activity in an In Vitro Seizure ModelEPILEPSIA, Issue 3 2000Michael Wong Summary: Purpose: Cyclosporine (CSA) toxicity represents a common cause of seizures in transplant patients, but the specific mechanisms by which CSA induces seizures are unknown. Although CSA may promote seizure activity by various metabolic, toxic, vascular, or structural mechanisms, CSA also has been hypothesized to modulate neuronal excitability directly. The objective of this study was to determine if CSA exerts direct epileptogenic actions on neurons in an in vitro seizure model. Methods: Combined hippocampal-entorhinal cortex slices from juvenile rats were exposed directly to artificial cerebro-spinal fluid (ACSF) containing either (a) 1.0 mM magnesium sulfate (control), (b) 1.0 mM sodium sulfate (low-magnesium), or (c) 1.0 mM magnesium sulfate + CSA (1,000,10,000 ng/ml). Spontaneous and evoked extracellular field potentials were recorded simultaneously from the dentate gyrus (DG) and CA3 hippocampal regions. Evoked synaptic responses were elicited by stimulation of the entorhinal cortex/perforant pathway. Results: CSA elicited spontaneous or stimulation-induced epileptiform activity in the DG or CA3 region of ,40% of slices, consisting of brief repetitive "interictal" discharges or prolonged stereotypical "ictal" discharges. Mean latency to epileptiform activity was ,100 min after onset of CSA application. The interictal discharges were inhibited by the non-NMDA antagonist, NBQX. Similar epileptiform activity was observed in low-magnesium ACSF without CSA. In control ACSF alone, epileptiform activity was not seen, except for rare spontaneous potentials in the DG. Conclusions: Direct effects of CSA on neuronal excitability and synaptic transmission may contribute to seizures seen in clinical CSA neurotoxicity. [source] | |||||||||||||||||||||||||||||||||||||||||||