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Contributing Factor (contributing + factor)
Kinds of Contributing Factor Selected AbstractsVARIATIONS OF THE INTERNAL PUDENDAL ARTERY AS A CONGENITAL CONTRIBUTING FACTOR TO AGE AT ONSET OF ERECTILE DYSFUNCTION IN JAPANESEBJU INTERNATIONAL, Issue 2 2008No abstract is available for this article. [source] Fetal Demise: What Were the Contributing Factors?NURSING FOR WOMENS HEALTH, Issue 4 2007Sue A. Woodson CNM First page of article [source] Strategies to reduce medication errors with reference to older adultsINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2006Brent Hodgkinson BSc (Hons) MSc GradCertPH GradCertEcon(Health) Abstract Background, In Australia, around 59% of the general population uses prescription medication with this number increasing to about 86% in those aged 65 and over and 83% of the population over 85 using two or more medications simultaneously. A recent report suggests that between 2% and 3% of all hospital admissions in Australia may be medication related with older Australians at higher risk because of higher levels of medicine intake and increased likelihood of being admitted to hospital. The most common medication errors encountered in hospitals in Australia are prescription/medication ordering errors, dispensing, administration and medication recording errors. Contributing factors to these errors have largely not been reported in the hospital environment. In the community, inappropriate drugs, prescribing errors, administration errors, and inappropriate dose errors are most common. Objectives, To present the best available evidence for strategies to prevent or reduce the incidence of medication errors associated with the prescribing, dispensing and administration of medicines in the older persons in the acute, subacute and residential care settings, with specific attention to persons aged 65 years and over. Search strategy, Bibliographic databases PubMed, Embase, Current contents, The Cochrane Library and others were searched from 1986 to present along with existing health technology websites. The reference lists of included studies and reviews were searched for any additional literature. Selection criteria, Systematic reviews, randomised controlled trials and other research methods such as non-randomised controlled trials, longitudinal studies, cohort or case,control studies, or descriptive studies that evaluate strategies to identify and manage medication incidents. Those people who are involved in the prescribing, dispensing or administering of medication to the older persons (aged 65 years and older) in the acute, subacute or residential care settings were included. Where these studies were limited, evidence available on the general patient population was used. Data collection and analysis, Study design and quality were tabulated and relative risks, odds ratios, mean differences and associated 95% confidence intervals were calculated from individual comparative studies containing count data where possible. All other data were presented in a narrative summary. Results, Strategies that have some evidence for reducing medication incidents are: ,,computerised physician ordering entry systems combined with clinical decision support systems; ,,individual medication supply systems when compared with other dispensing systems such as ward stock approaches; ,,use of clinical pharmacists in the inpatient setting; ,,checking of medication orders by two nurses before dispensing medication; ,,a Medication Administration Review and Safety committee; and ,,providing bedside glucose monitors and educating nurses on importance of timely insulin administration. In general, the evidence for the effectiveness of intervention strategies to reduce the incidence of medication errors is weak and high-quality controlled trials are needed in all areas of medication prescription and delivery. [source] "Spontaneous," delayed colon and rectal anastomotic complications associated with bevacizumab therapyJOURNAL OF SURGICAL ONCOLOGY, Issue 2 2008David A. August MD Abstract Bevacizumab, a humanized monoclonal antibody used to treat recurrent and metastatic colorectal cancer, targets the vascular endothelial growth factor (VEGF) molecule. It is hypothesized that bevacizumab works by both depriving tumors of the neovascularity they require to grow, and by improving local delivery of chemotherapy through alterations of tumor vasculature permeability and Starling forces. Complications of bevacizumab treatment include bowel ischemia and perforation, but to date, these complications have only rarely been described as occurring at the site of presumably healed anastomoses following surgery. We report two cases of delayed, "spontaneous" low anterior colorectal anastomotic dehiscence and one right colon anastomotic colocutaneous fistula associated with bevacizumab therapy. After seeing three patients with complications arising from apparently healed low anterior colorectal or right colon anastomoses following initiation of bevacizumab therapy for treatment of metastatic colorectal cancer, we reviewed the experience of The Cancer Institute of New Jersey (CINJ) with use of bevacizumab in approximately 50 patients between April 2004 and December 2006. The three index cases had been treated surgically at CINJ but received chemotherapy elsewhere. None of the 50 patients receiving bevacizumab at CINJ who had previous colon or rectal anastomoses were identified as having this complication. The medical records of the three index cases were reviewed and analyzed. Additionally, a Medline search was performed to identify other reports documenting similar cases. Two reports of related cases were found in the literature. In two of our index cases who underwent low anterior anastomoses, the patients had received preoperative pelvic irradiation before their initial low anterior resection. In one of the two cases, the initial resection was complicated by an anastomotic leak requiring proximal diversion and then subsequent stoma takedown. In both cases, the dehiscence occurred more than 1 year after anastomosis, and became evident 1,10 months following initiation of bevacizumab treatment. In the third index case, a colocutaneous fistula arising from the anastomotic site presented 5 months following right colon resection and 3 months after starting adjuvant systemic therapy with FOLFOX (5-fluorouracil (5-FU), leucovorin, and oxaliplatin) and bevacizumab. Delayed colorectal anastomotic complications may occur in association with bevacizumab therapy. Contributing factors may include anastomotic leak at the time of the original operation and history of anastomotic irradiation. Clinicians treating patients who receive bevacizumab following colectomy for colorectal cancer should be aware of this possible life-threatening complication. These findings may also be relevant to the design of trials of the use of bevacizumab for the postoperative adjuvant treatment of patients with colorectal cancer. J. Surg. Oncol. 2008;97:180,185. © 2007 Wiley-Liss, Inc. [source] Effects of cell structure and density on the properties of high performance polyimide foams,,POLYMERS FOR ADVANCED TECHNOLOGIES, Issue 2-3 2005Martha K. Williams Abstract Activity at the NASA Langley Research Center (LaRC) has focused on developing low density polyimide foam and foam structures which are made using monomeric solutions or salt solutions formed from the reaction of a dianhydride and diamine dissolved in a mixture of foaming agents and alkyl alcohol at room temperature. Monomer blends may be used to make a variety of polyimide foams with varying properties. The first foaming process developed consisted of thermal cycling the polymer precursor residuum and allowing the inflation of the particles to interact to create the foam. This process has resulted in foam structures with higher percentages of open cell content. Another innovative foaming process has been developed that begins with partially inflated microspheres, "friable balloons", with incomplete polymer molecular weight gain, which when fully cured into a foam results in more closed cell structures. In a research study performed by NASA Kennedy Space Center (KSC) and LaRC, two closely related polyimide foams, TEEK-H series and TEEK-L series, (4,4,-oxydiphthalic anhydride/3,4,-oxydianiline and 3,3,,4,4,-benzophenonetetracarboxylic acid dianhydride/4,4,-oxydianiline) were investigated for density effects and closed versus open cell effects on the thermal, mechanical, and flammability properties. Thermal conductivity data under the full range of vacuum pressures indicate that these materials are effective insulators under cryogenic conditions. Contributing factors such as cell content, density, and surface area were studied to determine the effects on thermal conductivity. Cone calorimetry data indicated decreased peak heat release rates for the closed cell system, TEEK-H friable balloons, compared to the TEEK foams with higher open cell content. Mechanical properties including tensile strength and compressive strength indicated that the materials have good structural integrity. Foams with more open cell content resulted in greater tensile and compressive strengths than the closed cell foams. The maximum closed cell content achieved in the "friable balloon" system was 78% at a foam density of 0.048 gm/cm3. Published in 2005 by John Wiley & Sons, Ltd. [source] Social outcomes of children with AD/HD: Contributing factors and implications for practicePSYCHOLOGY IN THE SCHOOLS, Issue 6 2001Melissa Stormont The purposes of this article are to provide a review of the literature in the area of social characteristics of children with AD/HD, and to outline interventions for working with specific social problems. Research has consistently documented that children with AD/HD are more rejected and less accepted by their peers. Possible reasons for this peer rejection will be presented in this article and include inappropriate social behavior, social knowledge deficits and biases, and negative interactions with peers and teachers. Because children with AD/HD are at risk for negative social outcomes, multiple intervention options are necessary. © 2001 John Wiley & Sons, Inc. [source] Mothers' evaluation of their caregiving for premature and full-term infants through the first year: Contributing factorsRESEARCH IN NURSING & HEALTH, Issue 3 2001Karen Pridham Abstract We explored change in mothers' evaluations of their caregiving through the first postterm year for full-term infants and for prematurely born, very low birth-weight infants with a history of lung disease, and we examined the contribution to this evaluation of infant, family, and mother conditions. Fifty-four mothers of premature infants and 49 mothers of full-term infants evaluated their caregiving relationship, performance, and satisfaction at 1, 4, 8, and 12 months infant postterm age. In addition, at the same intervals,1, 4, 8, and 12 months,mothers rated their symptoms of depression, infant responsiveness, and satisfaction with help from husband or partner. Positive and negative feeding behaviors of mother and of infant were rated from videotapes. Regression analysis, which included all rated variables, infant birth maturity/lung health status, and number of children in the mother's care, showed that the 1-month assessment differed significantly from the assessments at 4, 8, and 12 months. All conditions, except for infant birth maturity/lung health status and mother's positive feeding behavior, were significantly associated with caregiving evaluation. Findings support inclusion of infant, family, and mother conditions in a caregiving evaluation model. Infant responsiveness may be particularly salient to a mother's caregiving evaluation. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24: 157,169, 2001 [source] A review of maternal deaths at Goroka General Hospital, Papua New Guinea 2005,2008AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2010Karen SANGA Background:, Papua New Guinea is a developing country with a population of six million, facing significant geographical, cultural and economic barriers to the provision of antenatal and intrapartum care. The maternal mortality ratio (MMR) is an internationally regarded index of the quality of a country's maternity services; the most recently reported MMR for Papua New Guinea of 773 deaths per 100 000 births is one of the highest in the world. Aims:, To review information about women who died from pregnancy-related causes, both direct and indirect, in the Goroka General Hospital (GGH) during the period 1st January 2005 to 31st May 2008. Methods:, A retrospective review was undertaken of the charts of women recorded as dying in the Obstetrics and Gynecology (O&G) ward of GGH in the study period. Results:, The charts of 21 women who died from pregnancy-related causes were reviewed and information collated. Puerperal sepsis and sepsis complicating unsafe abortion were the most common causes of maternal death accounting for 48% deaths. Other causes included ectopic pregnancy and postpartum haemorrhage. Contributing factors included residence in a rural area, geographical and transport difficulties accessing care, non-use of family planning services, non-booking for antenatal care and late presentation in pregnancy or labour, and under-resourcing of services at GGH. The socio-economic status of most of the women was low, and where educational attainments were recorded these were also low. 71% of women identified themselves as practising Christians. Conclusions:, Better outreach services to provide health information and antenatal care, with specific counselling about the need for supervised delivery, are urgently required in the Eastern Highlands Province that GGH serves if numbers of maternal deaths are to be reduced. Working through churches in the region may be the most appropriate way to provide information and services to women because a majority of women adhere to Christianity and can be reached in this way. [source] Heel ultrasonography is not a good screening tool for bone loss after kidney and pancreas transplantationCLINICAL TRANSPLANTATION, Issue 5 2004Lynn R Mack-Shipman Abstract:, Background:, Solid organ transplant recipients, particularly simultaneous pancreas kidney recipients, are at high fracture risk. We tested whether quantitative ultrasonography (QUS) of the heel predicts bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) in solid organ transplant recipients. Methods:, Thirty-eight transplant recipients (22 Female/16 Male) were studied. Spine and hip BMD was measured with a Hologic DXA scanner. ,Stiffness' of the heel was measured with a Lunar Ultrasound densitometer and compared with BMD by DXA. Contributing factors to bone loss were also assessed. Results:, Mean age was 43.1 ± 1.3 yr. Simultaneous pancreas-kidney, kidney, and pancreas alone transplant recipients were assessed. Mean time post-transplantation was 3.0 ± 0.6 yr. Mean DXA spine T-score was ,1.15 ± 0.22 (mean ± SEM) and hip T-score was ,1.22 ± 0.20. There was no difference in mean T-score between women and men at the hip or spine. Mean right heel stiffness T-score was ,0.97 ± 0.25. There was no correlation between QUS and DXA at either the hip or spine in women or men. QUS had a false negative rate for identifying osteopenia or osteoporosis of 17% compared with DXA. The false positive rate for identifying osteopenia was 61%. Conclusions:, The QUS is an unacceptable tool for identifying those at risk for bone loss after kidney or pancreas transplantation. [source] Weight gain in bipolar disorder: pharmacological treatment as a contributing factorACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2008C. Torrent Objective:, The aim of this paper was to review the association of most commonly used psychopharmacological drugs with weight gain in bipolar disorder. Method:, Information was retrieved from a PubMed/Medline literature search reviewing weight gain in pharmacological studies in bipolar disorder. Results:, Obesity and overweight in bipolar disorder are partly related to prescribed drugs with a strong effect of clozapine and olanzapine. Lesser but still relevant weight gain is caused by quetiapine, risperidone, lithium, valproate, gabapentin and by some antidepressants. Ziprasidone, aripiprazole, carbamazepine and lamotrigine do not seem to cause significant overweight. Conclusion:, Careful monitoring of weight changes in patients before and after drug prescription should be implemented in the clinical routine and drugs which potentially cause weight gain should be avoided in overweight patients with bipolar disorder. Furthermore, eating habits and daily activities should be targeted as they may also have a significant impact on overall health and weight-related issues. [source] A link between endoplasmic reticulum stress-induced , -cell apoptosis and the group VIA Ca2+ -independent phospholipase A2 (iPLA2,)DIABETES OBESITY & METABOLISM, Issue 2010X. Lei Endoplasmic reticulum (ER) stress is becoming recognized as an important contributing factor in various diseases, including diabetes mellitus. Prolonged ER stress can cause , -cell apoptosis; however, the underlying mechanism(s) that contribute to this process are not well understood. Early reports suggested that arachidonic acid metabolites and a Ca2+ -independent phospholipase A2 (iPLA2) activity play a role in , -cell apoptosis. The PLA2 family of enzymes catalyse the hydrolysis of the sn -2 substituent (i.e. arachidonic acid) of membrane phospholipids. In light of our findings that the pancreatic islet , -cells are enriched in arachidonate-containing phospholipids and express the group VIA iPLA2,, we considered the possibility that iPLA2, participates in ER stress-induced , -cell apoptosis. Our work revealed a novel mechanism, involving ceramide generation and triggering of mitochondrial abnormalities, by which iPLA2, participates in the , -cell apoptosis process. Here, we review our evidence linking ER stress, , -cell apoptosis and iPLA2,. Continued studies in this area will increase our understanding of the contribution of iPLA2, to the evolution of diabetes mellitus and will further our knowledge of factors that influence , -cell health in diabetes mellitus and identify potential targets for future therapeutic interventions to prevent , -cell death. [source] Alcohol consumption in homicide victims in the city of São PauloADDICTION, Issue 12 2009Gabriel Andreuccetti ABSTRACT Aims To assess the association between alcohol use and victimization by homicide in individuals autopsied at the Institute of Legal Medicine in São Paulo, Brazil. Design Cross-sectional study. Setting Excessive consumption of alcohol is a serious public health issue and a major factor in triggering violent situations, which suggests a strong association between alcohol ingestion and becoming a victim of homicide. Participants Data from 2042 victims of homicides in 2005 were obtained from medical examiner reports. Measurements The victim's gender, age, ethnicity and blood alcohol concentration (BAC) were collected. The method of death and homicide circumstances, as well as the date, time and place of death were also studied. Findings Alcohol was detected in blood samples of 43% of the victims, and mean BAC levels were 1.55 ± 0.86 g/l. The prevalence of positive BAC levels was higher among men (44.1%) than women (26.6%), P < 0.01. Firearms caused most of the deaths (78.6%), and alcohol consumption was greater among victims of homicide by sharp weapons (P < 0.01). A greater proportion of victims with positive BAC were killed at weekends compared to weekdays (56.4 and 38.5%, respectively; P < 0.01), and the correlation between homicide rates and the average BAC for the central area of the city was positive (rs = 0.90; P < 0.01). Conclusions These results highlight alcohol as a contributing factor for homicide victimization in the greatest urban center in South America, supporting public strategies and future research aiming to prevent homicides and violence related to alcohol consumption. [source] Drinking patterns, dependency and life-time drinking history in alcohol-related liver diseaseADDICTION, Issue 4 2009Jennifer Hatton ABSTRACT Aims To examine the hypothesis that increases in UK liver deaths are a result of episodic or binge drinking as opposed to regular harmful drinking. Design A prospective survey of consecutive in-patients and out-patients. Setting The liver unit of a teaching hospital in the South of England. Participants A total of 234 consecutive in-patients and out-patients between October 2007 and March 2008. Measurements Face-to-face interviews, Alcohol Use Disorders Identification Test, 7-day drinking diary, Severity of Alcohol Dependence Questionnaire, Lifetime Drinking History and liver assessment. Findings Of the 234 subjects, 106 had alcohol as a major contributing factor (alcoholic liver disease: ALD), 80 of whom had evidence of cirrhosis or progressive fibrosis. Of these subjects, 57 (71%) drank on a daily basis; only 10 subjects (13%) drank on fewer than 4 days of the week,of these, five had stopped drinking recently and four had cut down. In ALD patients two life-time drinking patterns accounted for 82% of subjects, increasing from youth (51%), and a variable drinking pattern (31%). ALD patients had significantly more drinking days and units/drinking day than non-ALD patients from the age of 20 years onwards. Conclusions Increases in UK liver deaths are a result of daily or near-daily heavy drinking, not episodic or binge drinking, and this regular drinking pattern is often discernable at an early age. [source] Human sewage identified as likely source of white pox disease of the threatened Caribbean elkhorn coral, Acropora palmataENVIRONMENTAL MICROBIOLOGY, Issue 5 2010Kathryn Patterson Sutherland Summary Caribbean elkhorn coral, Acropora palmata, has been decimated in recent years, resulting in the listing of this species as threatened under the United States Endangered Species Act. A major contributing factor in the decline of this iconic species is white pox disease. In 2002, we identified the faecal enterobacterium, Serratia marcescens, as an etiological agent for white pox. During outbreaks in 2003 a unique strain of S. marcescens was identified in both human sewage and white pox lesions. This strain (PDR60) was also identified from corallivorious snails (Coralliophila abbreviata), reef water, and two non-acroporid coral species, Siderastrea siderea and Solenastrea bournoni. Identification of PDR60 in sewage, diseased Acropora palmata and other reef invertebrates within a discrete time frame suggests a causal link between white pox and sewage contamination on reefs and supports the conclusion that humans are a likely source of this disease. [source] Effects of pulp and paper mill effluent on fish: A temporal assessment of fish health across sampling cyclesENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 2 2010Timothy J. Barrett Abstract The Canadian environmental effects monitoring (EEM) program is a regulated, cyclical, industry-funded program designed to determine whether receiving water impacts exist when a mill is in compliance with its discharge limits. The results from three cycles of the fish monitoring program (1992 to 2004) are available from over 200 surveys of fish compared between sites located upstream and downstream of pulp and paper mill effluent outfalls. Previous meta-analyses have shown a national average response pattern across cycles characterized by an increase in endpoints measuring energy storage and growth and a decrease in a reproductive endpoint, consistent with a response of nutrient enrichment in combination with some form of metabolic disruption. Although the national average pattern of effects was temporally consistent, there was some variability in the magnitude of effects among cycles. Questions were raised as to whether the intercycle variability was due to changes in effluent quality or due, at least in part, to other factors. The present study compares responses over the first three cycles, and shows that the choice of sentinel species is likely to be a major contributing factor to the variability in observed effects. Subset analyses using studies from mills that used the same sentinel species across cycles reveal fairly uniform responses and little evidence of significant improvements in overall fish health from cycles one to three. However, a meta-analysis using 1991 data collected from 10 mills before the implementation of the EEM program and data from the same mills collected during cycles one to three of the program reveal significantly reduced effects on relative liver weight and potential improvements in other endpoints. Environ. Toxicol. Chem. 2010;29:440,452. © 2009 SETAC [source] Application of toxicity identification evaluation procedures for characterizing produced water using the tropical mysid, Metamysidopsis insularisENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 5 2004Najila Elias-Samlalsingh Abstract Toxicity identification evaluations (TIEs) were performed on seven produced water (PW) effluents from inland discharge facilities operated in Trinidad and Tobago, a Caribbean tropical country with one of the oldest commercial oil industries in the world. The research was performed to determine the presence and magnitude of toxicity and characterize which toxicants are responsible for observed effects. Marine effluent toxicity characterizations with Metamysidopsis insularis revealed high whole acute toxic-unit response for produced water ranged from 8.1 to >17.0 acute toxic-unit (initial toxicity test) and 5.7 to 1,111 acute toxic-unit (baseline toxicity test). Toxicity test results for all sites except one, which had the highest toxicity, are comparative with similar studies on produced water. The toxicological causality of this complex mixture differed for each PW with nonpolar organics being consistently toxic in all samples. Other potential toxicants contributing to overall toxicity to a much lesser extent were metals, ammonia, and volatile organic compounds. With the use of sodium thiosulfate and filtration manipulations for only PW6 sample, there was very slight reduction in toxicity; therefore, oxidants and filterable materials were not a great contributing factor. Whole effluent toxicity also can be attributed to ionic imbalance and the very stable oil-in-water emulsion that consists of fine oil droplets (less than 0.1,10 ,m with an average diameter of 2.5 ,m). This investigation is the first of its type in Trinidad and demonstrates clearly the applicability of this test method and local test species for evaluating complex effluents in tropical environments. [source] Videoendoscopic evaluation of the upper respiratory tract in 93 sport horses during exercise testing on a high-speed treadmillEQUINE VETERINARY JOURNAL, Issue S36 2006S. H. FRANKLIN Summary Reasons for performing study: Videoendoscopy of the upper respiratory tract (URT) during high-speed treadmill exercise has proved to be invaluable in the assessment of URT dysfunction in racehorses. However, very little information exists regarding dynamic airway collapse in other sport horses used in nonracing equestrian disciplines. Objectives: To evaluate the videoendoscopic findings at rest and during exercise in a mixed population of sport horses referred for investigation of poor athletic performance and/or abnormal respiratory noise. Methods: Videoendoscopy of the upper airway was performed at rest and during high-speed treadmill exercise in 93 horses. Results: Dynamic airway obstructions were diagnosed in 77% of horses and were frequently complex in nature. The most common forms of dynamic collapse included soft palate dysfunction (54%), dynamic laryngeal collapse (38%), axial deviation of the aryepiglottic folds (24%) and pharyngeal wall collapse (18%). In the majority of horses, no obvious abnormalities were identified at rest. Enforced poll flexion was found to be a contributing factor in 24% of cases. Conclusions: Dynamic obstructions of the URT were a common cause of poor performance and/or abnormal respiratory noise in sport horses referred for investigation of performance problems. Potential relevance: This study highlights the importance of videoendoscopic evaluation of the URT during exercise in horses utilised for equestrian sports where exercise during competition is submaximal in nature. [source] Pressor and vascular effects of cardiac glycosidesEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue S2 2001W. Kirch Background: For the past two decades, it has generally been accepted ('Blaustein hypothesis') that cardiac glycosides such as ouabain and digoxin increase the sodium and calcium content of smooth muscle cells, so inducing arterial vasoconstriction and a rise in blood pressure. Recent data from an experimental study we carried out led us to question this assumption. Design: A retrospective literature survey covering 20 years and including animal and human studies was performed. Representative results are presented. Results: Contradictory effects of cardiac glycosides on blood pressure and vasculature have been described. Increased, decreased or unaltered blood-pressure values have been observed following administration of the glycosides ouabain, digoxin and digitoxin. Moreover, vasoconstricting as well as vasodilating effects of cardiac glycosides have been demonstrated. Several recent studies show that cardiac glycosides such as digoxin and digitoxin can lead to a reduction of at least diastolic blood pressure. Conclusion: A slight vasodilation of resistance vessels followed by a fall in diastolic blood pressure could be a contributing factor for the beneficial effects of cardiac glycosides in patients with congestive heart failure. This vasodilation may be caused by central (neurohumoral) effects of digitalis glycosides. [source] Blood morphine levels in naltrexone-exposed compared to non-naltrexone-exposed fatal heroin overdosesADDICTION BIOLOGY, Issue 3 2003DIANE ARNOLD-REED The aim of this study was to investigate the association between prior exposure to naltrexone and increased risk of fatal heroin overdose using a review of toxicology reports for heroin-related fatalities between July 1997 to August 1999 for two groups: those treated with oral naltrexone and those who were not treated. Additional information for the oral naltrexone group was obtained from clinic files. Naltrexone-treated deaths were identified from the patient database at the Australian Medical Procedures Research Foundation (AMPRF), Perth, Western Australia (WA) through the Western Australian Department of Health, Data Linkage Project. Non-treated cases were identified from the database at the Forensic Science Laboratory, State Chemistry Centre (WA). We identified and investigated blood morphine concentrations following 21 fatal heroin overdoses with prior exposure to naltrexone and in 71 non-naltrexone-exposed cases over the same time period. The proportion of deaths where heroin use was a major contributing factor was little different in the non-naltrexone compared to the naltrexone-exposed group. Furthermore, in ,acute opiate toxicity' deaths, blood morphine levels were lower in non-naltrexone-exposed compared with naltrexone-exposed cases. Although there was a higher number of deaths designated as rapid (i.e. occurring within 20 minutes) in the naltrexone-exposed (89%) compared with the non-exposed group (72%) this was not statistically significant. Other drug use in relation to heroin-related fatalities is discussed. Findings do not support the hypothesis that prior exposure to naltrexone increases sensitivity to heroin toxicity. [source] Pine mistletoe (Viscum album ssp. austriacum) contributes to Scots pine (Pinus sylvestris) mortality in the Rhone valley of SwitzerlandFOREST PATHOLOGY, Issue 5 2006M. Dobbertin Summary In recent years unusual high mortality of Scots pine (Pinus sylvestris) has been observed in the Swiss Rhone Valley. The exact causes, however, are not known. At a 2-ha monitoring plot, tree mortality and crown condition have been monitored since 1996. Between 1996 and 2004, 59% of the Scots pines died, most of them following the drought periods 1996,1998 and 2003,2004, while only 15% of the deciduous trees died. Crown transparency, needle discolouration, dead branch percentage, mistletoe (Viscum album ssp. austriacum) rating, Tomicus sp. shoot feeding, male flowering effect, tree stem diameter, crown shading and social tree class assessed in 1998 were used in a logistic regression model to predict tree mortality. Crown transparency, mistletoe rating and percentage of dead branches were found significant in the model and the probability of tree mortality increased with increasing rankings of these parameters. Needle discolouration could be used to substitute ,dead branch percentage' as predictor. While crown transparency increased with mistletoe rating, for trees in the same transparency class, trees with medium and heavy mistletoe infection were two to four times more likely to die than trees with no or only low mistletoe infection. For the surviving trees we found that trees with mistletoes showed a significantly higher increase in transparency in the year following a drought than trees without, while in a drought year the opposite was true. At the beginning of the observations no significant differences in transparency had been found between the trees with and without mistletoe. However, by the end of the observation period trees with mistletoe had significantly higher crown transparency. We conclude that mistletoe infection can be considered as both a predisposing factor for tree death, by increasing needle loss following drought and a contributing factor by increasing water stress during drought. Résumé Une forte mortalité des pins sylvestres (Pinus sylvestris) a été observée ces dernières années dans la vallée du Rhône en Suisse. Les causes exactes n'en sont pas connues. La mortalité des arbres et l'état des houppiers ont été suivis depuis 1996 dans une parcelle de 2 ha. Entre 1996 et 2004, 59% des pins sylvestres sont morts, la plupart après les périodes de sécheresse de 1996,98 et 2003,2004, comparéà 15% pour les feuillus. La transparence des houppiers, le jaunissement des aiguilles, le pourcentage de mortalité de branches, une note d'importance du gui (Viscum album ssp. austriacum), les attaques d'alimentation sur pousses par Tomicus sp., la floraison mâle, le diamètre du tronc, l'ombrage du houppier et le statut social des arbres, mesurés en 1998, ont été utilisés dans un modèle de régression logistique pour prédire la mortalité des arbres. La transparence des houppiers, le taux de gui et le pourcentage de branches mortes sont des variables significatives, dont l'augmentation est associée à une augmentation de la probabilité de mortalité des arbres. Le jaunissement des aiguilles pourrait être substituée à la mortalité des branches comme variable prédictrice. Tandis que la transparence des houppiers augmente avec le taux de gui, au sein de la même classe de transparence, les arbres avec une infestation de gui moyenne à forte ont une probabilité de mortalité 2 à 4 fois plus élevée que les arbres à infestation faible ou nulle. Chez les arbres survivants, on observe que les arbres porteurs de gui ont une augmentation plus forte de la transparence du houppier l'année suivant une sécheresse que les arbres sans gui, l'inverse étant vrai pendant une année sèche. La différence de transparence des houppiers entre arbres porteurs de gui et arbres sans gui n'était pas significative au début des observations, alors qu'à la fin de la période, les arbres avec gui ont une transparence plus forte. Nous concluons que l'infestation par le gui peut être considérée à la fois comme un facteur prédisposant à la mortalité, en augmentant la perte d'aiguilles après sécheresse, et un facteur contribuant, en augmentant le stress hydrique pendant la sécheresse. Zusammenfassung Seit einigen Jahren werden im Schweizer Rhonetal hohe Absterberaten der gemeinen Kiefer (Pinus sylvestris L.) beobachtet. Die genauen Ursachen sind bis jetzt unbekannt. Auf der zwei Hektar grossen langfristigen Waldökosystemfläche (LWF) Visp werden seit 1996 jährlich Absterberaten, Kronenverlichtung, Mistelbefall (Viscum album ssp. austriacum) und andere Symptome aufgenommen. Zwischen 1996 und 2004 sind 59% aller Föhren auf der Fläche abgestorben, die meisten nach den Trockenperioden 1996,98 und 2003,2004. Dagegen starben nur 15% der Laubbäume ab. Kronenverlichtung, Nadelverfärbung, Totast- und Totzweiganteil (als Indikatoren der Vitalität des Baumes), Mistelbefallsklasse, Triebabwurf durch Waldgärtner, männliche Blütenbildung, Stammdurchmesser, Kronenkonkurrenz und soziale Stellung, alle im Jahr 1998 erhoben, wurden in einer logistischen Regression zur Bestimmung der Absterbewahrscheinlichkeit auf Signifikanz getestet. Kronenverlichtung, Mistelbefallsklasse und Totastanteil waren in dem Model signifikant. Die Wahrscheinlichkeit des Absterbens stieg dabei mit ansteigender Kronenverlichtung, ansteigendem Mistelbefall und ansteigendem Totastanteil. Der Totastanteil konnte im Model durch die Nadelverfärbung ersetzt werden. Die Kronenverlichtung stieg mit dem Mistelbefall an. Bei gleicher Verlichtung starben jedoch Bäume mit mittlerem und starkem Mistelbefall zwei- bis viermal häufiger ab als Bäume ohne oder mit leichtem Mistelbefall. Von den überlebenden Bäumen zeigten solche mit Mistelbefall einen deutlichen Anstieg der Transparenz im Jahr nach Beginn der Trockenheit im Vergleich zu den Bäumen ohne Misteln, während im Jahr der Trockenheit das Umgekehrte der Fall war. Zu Beginn der Beobachtung ergaben sich keine signifikanten Unterschiede in der Kronentransparenz der überlebenden Bäume mit und ohne Misteln. Am Ende der Beobachtungsperiode wiesen jedoch die Bäume mit Misteln signifikant höhere Kronenverlichtungen auf. Wir schliessen daraus, dass die Misteln auf der einen Seite den Baum langfristig schwächen, indem sie zur Reduzierung der Nadelmasse führen und sie auf der anderen Seite während Trockenheit durch erhöhten Wasserstress zum vorzeitigen Absterben beitragen. [source] Functional roles of remnant plant populations in communities and ecosystemsGLOBAL ECOLOGY, Issue 6 2000Ove Eriksson Abstract A hypothesis is suggested for functional roles of remnant plant populations in communities and ecosystems. A remnant population is capable of persistence during extended time periods, despite a negative population growth rate, due to long-lived life stages and life-cycles, including loops that allow population persistence without completion of the whole life cycle. A list of critera is suggested to help identification of remnant plant populations. Several community and ecosystem features may result from the presence of remnant plant populations. Apart from increasing community and ecosystem resilience just by being present, remnant populations may contribute to resilience through enhancing colonization by other plant species, by providing a persistent habitat for assemblages of animals and microorganisms, and by reducing variation in nutrient cycling. It is suggested that the common ability of plants to develop remnant populations is a contributing factor to ecosystem stability. Remnant populations are important for the capacity of ecosystems to cope with the present-day impact caused by human society, and their occurrence should be recognized in surveys of threatened plant species and communities. [source] Tripstar: A Comprehensive Patient-Based Approach to Compare TriptansHEADACHE, Issue 2002Michel D. Ferrari MD Several second-generation triptans have been introduced that differ in their pharmacologic profiles relative to each other and to sumatriptan. As therapeutic options multiply, clinicians must be able to distinguish among these compounds. Recently, a meta-analysis was conducted on data from 53 double-blind, randomized, placebo- or active-controlled trials involving over 24 000 patients receiving oral triptans. Results indicated that almotriptan 12.5 mg, rizatriptan 10 mg, and eletriptan 80 mg are generally superior to sumatriptan 100 mg based on individual treatment attributes, such as pain relief, sustained pain freedom, consistency of response, and tolerability. Meta-analyses are limited, however, as the analysis can only be performed for individual end points, whereas patients and prescribers balance a variety of treatment attributes when assessing drug acceptability. A flexible overall scoring system ("Tripstar") is proposed that compares triptans to a hypothetical "ideal" using meta-analysis data combined with ratings of the relative importance of clinically relevant treatment criteria. An informal test of the Tripstar model indicated that sumatriptan is most similar to a hypothetical ideal for both mild and severe migraine, primarily due to its high worldwide clinical exposure. However, after exclusion of worldwide exposure as a contributing factor, almotriptan 12.5 mg is most similar to the ideal, principally because of its good tolerability. Further tests of the Tripstar model are planned that will gauge the relative importance of a broader range of attributes. [source] Inactivation of oxidized and S -nitrosylated mitochondrial proteins in alcoholic fatty liver of rats,HEPATOLOGY, Issue 5 2006Kwan-Hoon Moon Increased oxidative/nitrosative stress is a major contributing factor to alcohol-mediated mitochondrial dysfunction. However, which mitochondrial proteins are oxidatively modified under alcohol-induced oxidative/nitrosative stress is poorly understood. The aim of this study was to systematically investigate oxidized and/or S -nitrosylated mitochondrial proteins and to use a biotin- N -maleimide probe to evaluate their inactivation in alcoholic fatty livers of rats. Binge or chronic alcohol exposure significantly elevated nitric oxide, inducible nitric oxide synthase, and ethanol-inducible CYP2E1. The biotin- N -maleimide-labeled oxidized and/or S -nitrosylated mitochondrial proteins from pair-fed controls or alcohol-fed rat livers were subsequently purified with streptavidin-agarose. The overall patterns of oxidized and/or S -nitrosylated proteins resolved by 2-dimensional polyacrylamide gel electrophoresis were very similar in the chronic and binge alcohol treatment groups. Seventy-nine proteins that displayed differential spot intensities from those of control rats were identified by mass spectrometry. These include mitochondrial aldehyde dehydrogenase 2 (ALDH2), ATP synthase, acyl-CoA dehydrogenase, 3-ketoacyl-CoA thiolase, and many proteins involved in chaperone activity, mitochondrial electron transfer, and ion transport. The activity of 3-ketoacyl-CoA thiolase involved in mitochondrial ,-oxidation of fatty acids was significantly inhibited in alcohol-exposed rat livers, consistent with hepatic fat accumulation, as determined by biochemical and histological analyses. Measurement of activity and immunoblot results showed that ALDH2 and ATP synthase were also inhibited through oxidative modification of their cysteine or tyrosine residues in alcoholic fatty livers of rats. In conclusion, our results help to explain the underlying mechanism for mitochondrial dysfunction and increased susceptibility to alcohol-mediated liver damage. (HEPATOLOGY 2006;44:1218,1230.) [source] Occult hepatitis B virus infection in a North American adult hemodialysis patient populationHEPATOLOGY, Issue 5 2004Gerald Y. Minuk Hepatitis B virus (HBV) infections continue to occur in adult hemodialysis units. A possible contributing factor is the presence of occult HBV (serum hepatitis B surface antigen [HBsAg] negative but HBV DNA positive). Two hundred forty-one adult hemodialysis patients were screened for occult HBV. HBV DNA testing was performed by real-time polymerase chain reaction (PCR) with 2 independent primer sets (core promoter and surface). Two (0.8%) of the 241 patients were HBsAg positive. Of the remaining 239 HBsAg-negative patients, 9 (3.8%) were HBV DNA positive. Viral loads in these individuals were low (102 -104 viral copies/mL). Seven of the 9 (78%) were nt 587 mutation (sG145R mutant) positive. Demographic, biochemical, and HBV serological testing did not help to identify those with occult HBV. In conclusion, the prevalence of occult HBV in adult hemodialysis patients in this North American urban center is approximately 4 to 5 times higher than standard HBsAg testing would suggest. The majority of these infections are associated with low viral loads and a high prevalence of the sG145R mutant. Finally, the demographic, biochemical, and/or serological features of HBV DNA,positive subjects do not distinguish these individuals from the remainder of the dialysis patient population. (HEPATOLOGY 2004; 40:1072,1077.) [source] Networks of Empire: Linkage and Reciprocity in Nineteenth-Century Irish and Indian HistoryHISTORY COMPASS (ELECTRONIC), Issue 3 2009Barry Crosbie Recent debates surrounding Ireland's historical relationship with the British empire have focused almost exclusively upon its constitutional and political ties with Britain. The question of Ireland's colonial status continues to be heavily debated in Irish historiography and has been a contributing factor in obscuring our wider understanding of the complexity of Ireland's involvement in empire. For over 200 years, Ireland and India were joined together by an intricate series of networks that were borne out of direct Irish involvement in British imperialism overseas. Whether as migrants, soldiers, administrators, doctors, missionaries or educators, the Irish played an important role in administering, governing and populating vast areas of Britain's eastern empire. This article discusses new approaches to the study of Ireland's imperial past that allow us to move beyond the old ,coloniser-colonised' debate, to address the key issue of whether Ireland or the varieties of Irishness of its imperial servants and settlers made a specific difference to the experience of empire. By highlighting the multiplicity of Irish connections within the context of the nineteenth-century British empire in India, this article describes how imperial networks were used by contemporaries (settlers, migrants and indigenous agents) as mechanisms for the exchange of a whole set of ideas, practices and goods between Ireland and India during the colonial era. [source] The full spectrum of holoprosencephaly-associated mutations within the ZIC2 gene in humans predicts loss-of-function as the predominant disease mechanism,,HUMAN MUTATION, Issue 4 2009Erich Roessler Abstract Mutations of the ZIC2 transcription factor gene are among the most common heterozygous variations detected in holoprosencephaly (HPE) patients, a patient group who lack critical midline forebrain specification due to defective embryonic signaling during development. Recent studies indicate that complete deficiency of the related murine Zic2 transcription factor can also be a contributing factor to variable midline deficiencies, presenting during mid-gastrulation, that could explain similar forebrain anomalies in this model system. Here we collect and summarize all available mutations in the human ZIC2 gene detected in HPE patients (21 published and 62 novel). Our analysis corroborates this mechanism proposed in mice by predicting loss-of-function as the likely pathogenetic mechanism common to most, if not all, of these mutations in HPE. Published 2009 Wiley-Liss, Inc. [source] Radiation exposure and the justification of computed tomography scanning in an Australian hospital emergency departmentINTERNAL MEDICINE JOURNAL, Issue 11 2009M. Street Abstract In an emergency department (ED), computed tomography (CT) is particularly beneficial in the investigation of high-speed trauma patients. With the advent of multidetector CT (MDCT) scanners, it is becoming faster and easier to conduct scans. In recent years, this has become evident with an increasing number of CT requests. Patients who have multiple CT scans during their hospital stay can receive radiation doses that have an increased theoretical risk of induction of cancer. It is essential that the clinical justification for each CT scan be considered on an individual basis and that due consideration is given to the radiation risk and possible diagnostic benefit. The current lack of a central State or Commonwealth data repository for medical images is a contributing factor to excessive radiation dosage to the population. The principles of justification and radiation risks are discussed in this study. [source] Prostaglandin F2, stimulates MEK-ERK signalling but decreases the expression of alkaline phosphatase in dental pulp cellsINTERNATIONAL ENDODONTIC JOURNAL, Issue 6 2010M. C. Chang Chang MC, Chen YJ, Lee MY, Lin LD, Wang TM, Chan CP, Tsai YL, Wang CY, Lin BR, Jeng JH. Prostaglandin F2, stimulates MEK-ERK signalling but decreases the expression of alkaline phosphatase in dental pulp cells. International Endodontic Journal, 43, 461,468, 2010. Abstract Aim, To study prostaglandin F2, (PGF2,) receptor expression and downstream signalling in cultured human dental pulp cells and the effect of PGF2, on the alkaline phosphatase (ALP) activity of dental pulp cells. Methodology, Human dental pulp cells were cultured and exposed to PGF2,. The expression of PGF2, (FP) receptors was analysed by reverse transcriptase polymerase chain reaction (RT-PCR) and Western blotting. The activation of extracellular regulated kinase (ERK) and cAMP responsive element binding protein/activating transcription factor-1 (CREB/ATF-1) signalling was determined by Western blotting. The expression of ALP in pulp cells after exposure to PGF2, was evaluated by ALP staining and PCR. Results, Dental pulp cells expressed FP receptor mRNA and protein. Exposure to PGF2, revealed little cytotoxicity to pulp cells. PGF2, induced both ERK and CREB/ATF-1 phosphorylation in pulp cells. Exposure to PGF2, (>1 ,mol L,1) further decreased the ALP activity and mRNA expression. However, U0126 (an inhibitor of MEK1) showed little preventive effect on the decline of ALP activity in dental pulp cells by PGF2,. Conclusion, PGF2, may potentially activate FP receptors leading to ERK/CREB-ATF-1 activation during its production in inflamed dental pulp. PGF2, attenuated the ALP activity of pulp cells possibly via pathways not solely by MEK/ERK activation. PGF2, is a contributing factor of pulpal inflammation by regulating the activities of pulp cells. [source] An ,upside-down' view of rural health careINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 2 2001Mary Mahoney Abstract Access to high quality health care services plays an important part in the health of rural communities and individuals. This fact is reflected in efforts by governments to improve the quality of such services through better targeting of funds and more efficient management of services. In Australia, the difficulties experienced by rural communities in attracting and retaining doctors has long been recognized as a contributing factor to the relatively higher levels of morbidity and mortality in rural areas. However, this paper, based on a study of two small rural communities in Australia, suggests that resolving the health problems of rural communities will require more than simply increasing the quality and accessibility of health services. Health and well-being in such communities relates as much to the sense of community cohesion as it does to the direct provision of medical services. Over recent years, that cohesion has diminished, undermined in part by government policies that have fuelled an exodus from small rural communities to urban areas. Until governments begin to take an ,upside-down' perspective, focusing on building healthy communities rather than simply on building hospitals to make communities healthy, the disadvantages faced by rural people will continue to be exacerbated. [source] Evaluation of coexistence of the Human Herpesvirus type 8 (HHV-8) infection and pemphigusINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2010Naser Tayyebi Meibodi Associate Professor Background, Human Herpesvirus type 8 (HHV-8) is a new member of the herpes virus family, first found in the tissue of acquired immune deficiency syndrome (AIDS)-related Kaposi's sarcoma. Environmental factors including viral infection may play a role in the onset and/or development of pemphigus. Some studies based on polymerase chain reaction findings suggest an association between HHV-8 and pemphigus. The aim of this study is investigation of the association of pemphigus with HHV-8 and the relationship between inflammatory and acantholytic cells with HHV-8 infection. Methods, Tissue-extracted DNA from 41 paraffin-embedded skin tissues from patients first presenting with pemphigus was tested using nested PCR for the presence of HHV-8. A total of 37 cases had pemphigus vulgaris (PV) and 4 patients had pemphigus foliaceus (PF). For our control group, normal skin of 21 cosmetic surgery patients were included. Furthermore, microscopic slides with H&E staining were evaluated for the number of inflammatory and acantholytic cells per microscopic field. Results, Skin lesions from 13 of 37 patients (35.1%) with PV and 2 of 4 cases (50%) with PF were positive for HHV-8 DNA. All specimens in our control group were negative for this virus. Conclusion, HHV-8 infection might be a contributing factor in the initiation or development of pemphigus. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||