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Devastating Consequences (devastating + consequence)
Selected AbstractsVancomycin covalently bonded to titanium alloy prevents bacterial colonizationJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 7 2007Valentin Antoci Jr. Abstract Periprosthetic infection is a devastating consequence of implant insertion and can arise from hematogenous sources or surgical contamination. Microbes can preferentially colonize the implant surface and, by forming a biofilm, escape immune surveillance. We hypothesized that if an antibiotic can be tethered to a titanium alloy (Ti) surface, it will inhibit bacterial colonization, prevent biofilm formation, and avert late-stage infection. To test this hypothesis, a Ti rod was covalently derivatized with vancomycin. Reaction efficiencies were evaluated by colorimetric and spectrophotometric measurements. The vancomycin-modified surface was stable in aqueous solutions over extended time periods and maintained antibiotic coverage, even after press-fit insertion into a cadaverous rat femora. When evaluated using fluorescently labeled bacteria, or by direct colony counts, the surface-bound antibiotic prevented bacterial colonization in vitro after: (1) exposure to high levels of S. aureus; (2) extended incubation in physiological buffers; and (3) repeated bacterial challenges. Importantly, whereas the vancomycin-derivitized pins prevented bacterial colonization, S. aureus adhered to control pins, even in the presence of concentrations of vancomycin that exceeded the strain MIC. These results demonstrate that we have effectively engineered a stable, bactericidal Ti surface. This new surface holds great promise in terms of mitigating or preventing periprosthetic infection. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:858,866, 2007 [source] Epigenetic dysregulation in cognitive disordersEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 1 2009Johannes Gräff Abstract Epigenetic mechanisms are not only essential for biological functions requiring stable molecular changes such as the establishment of cell identity and tissue formation, they also constitute dynamic intracellular processes for translating environmental stimuli into modifications in gene expression. Over the past decade it has become increasingly clear that both aspects of epigenetic mechanisms play a pivotal role in complex brain functions. Evidence from patients with neurodegenerative and neurodevelopmental disorders such as Alzheimer's disease and Rett syndrome indicated that epigenetic mechanisms and chromatin remodeling need to be tightly controlled for proper cognitive functions, and their dysregulation can have devastating consequences. However, because they are dynamic, epigenetic mechanisms are also potentially reversible and may provide powerful means for pharmacological intervention. This review outlines major cognitive disorders known to be associated with epigenetic dysregulation, and discusses the potential of ,epigenetic medicine' as a promising cure. [source] Mechanisms underlying the inability to induce area CA1 LTP in the mouse after traumatic brain injuryHIPPOCAMPUS, Issue 6 2006E. Schwarzbach Abstract Traumatic brain injury (TBI) is a significant health issue that often causes enduring cognitive deficits, in particular memory dysfunction. The hippocampus, a structure crucial in learning and memory, is frequently damaged during TBI. Since long-term potentiation (LTP) is the leading cellular model underlying learning and memory, this study was undertaken to examine how injury affects area CA1 LTP in mice using lateral fluid percussion injury (FPI). Brain slices derived from FPI animals demonstrated an inability to induce LTP in area CA1 7 days postinjury. However, area CA1 long-term depression could be induced in neurons 7 days postinjury, demonstrating that some forms of synaptic plasticity can still be elicited. Using a multidisciplined approach, potential mechanisms underlying the inability to induce and maintain area CA1 LTP were investigated. This study demonstrates that injury leads to significantly smaller N -methyl- D -aspartate potentials and glutamate-induced excitatory currents, increased dendritic spine size, and decreased expression of ,-calcium calmodulin kinase II. These findings may underlie the injury-induced lack of LTP and thus, contribute to cognitive impairments often associated with TBI. Furthermore, these results provide attractive sites for potential therapeutic intervention directed toward alleviating the devastating consequences of human TBI. © 2006 Wiley-Liss, Inc. [source] Acquired haemophilia masked by warfarin therapyINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1 2007C. M. VADIKOLIA Summary Acquired haemophilia is a rare phenomenon and prompt diagnosis is essential for successful treatment. Early laboratory detection could minimize its potentially devastating consequences and reduce mortality but when a masking element such as anticoagulant therapy is present, delay in diagnosis is not uncommon. A prolonged activated partial thromboplastin time (APTT) may be falsely attributed to warfarin alone, particularly when it is associated with oral anticoagulant overdose. We describe two patients on treatment with warfarin who presented with a bleeding diathesis and disproportionately prolonged APTT, which led to the diagnosis of antibodies directed against factor VIII. [source] Views of xerostomia among health care professionals: a qualitative studyJOURNAL OF CLINICAL NURSING, Issue 6 2009Solgun Folke Aim., To explore and describe views of xerostomia among health care professionals. Background., Xerostomia (dry mouth) is caused by changes in quality and quantity of saliva due to poor health, certain drugs and radiation therapy. It is a common symptom, particularly among older people and has devastating consequences with regard to oral health and general well-being. Methods., Data were obtained and categorised by interviewing 16 health care professionals. Qualitative content analysis was chosen as the method of analysis. Design., Qualitative. Results., The latent content was formulated into a theme: xerostomia is a well-known problem, yet there is inadequate management of patients with xerostomia. The findings identified three categories expressing the manifest content: awareness of xerostomia, indifferent attitude and insufficient support. Conclusions., Although xerostomia was recognised as commonly occurring, it was considered to be an underestimated and an ignored problem. Proper attention to conditions of xerostomia and subsequent patient management were viewed as fragmentary and inadequate. Additional qualitative studies among patients with xerostomia would be desirable to gain further understanding of the problems with xerostomia, its professional recognition and management. Relevance to clinical practice., A holistic view, positive professional attitudes and enhanced knowledge of xerostomia seem essential to augment collaboration among health care professionals and to improve compassion for and support of patients with xerostomia. [source] Syphilis: An old enemy still lurksJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2006Assistant Professor of Clinical Nursing, FNP Family Nurse Practitioner, L. A. Ferguson MSN Abstract Purpose: To review the problem of increasing cases of syphilis as a communicable disease and to review different presentations of syphilis and to discuss treatment guidelines. Data sources: Extensive review of worldwide scientific literature on the epidemiology, diagnosis, and treatment of syphilis. Conclusions: Syphilis is an infectious sexually transmitted disease, which may have devastating consequences. Previously declining rates have led to complacency in prevention and diagnosis. Primary prevention includes education regarding safer sexual practices. Secondary prevention includes early identification via screening and treatment. Implications for practice: Syphilis is a contagious disease that has devastating consequences if not diagnosed and treated. Providers should keep ever vigilant in its identification. Specifically, it should be considered when evaluating all symptom-less dermatological lesions. [source] Anticipating catastrophes through extreme value modellingJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES C (APPLIED STATISTICS), Issue 4 2003Stuart Coles Summary. When catastrophes strike it is easy to be wise after the event. It is also often argued that such catastrophic events are unforeseeable, or at least so implausible as to be negligible for planning purposes. We consider these issues in the context of daily rainfall measurements recorded in Venezuela. Before 1999 simple extreme value techniques were used to assess likely future levels of extreme rainfall, and these gave no particular cause for concern. In December 1999 a daily precipitation event of more than 410 mm, almost three times the magnitude of the previously recorded maximum, caused devastation and an estimated 30000 deaths. We look carefully at the previous history of the process and offer an extreme value analysis of the data,with some methodological novelty,that suggests that the 1999 event was much more plausible than the previous analyses had claimed. Deriving design parameters from the results of such an analysis may have had some mitigating effects on the consequences of the subsequent disaster. The themes of the new analysis are simple: the full exploitation of available data, proper accounting of uncertainty, careful interpretation of asymptotic limit laws and allowance for non-stationarity. The effect on the Venezuelan data analysis is dramatic. The broader implications are equally dramatic; that a naïve use of extreme value techniques is likely to lead to a false sense of security that might have devastating consequences in practice. [source] Social Correlates of Party System Demise and Populist Resurgence in VenezuelaLATIN AMERICAN POLITICS AND SOCIETY, Issue 3 2003Kenneth M. Roberts ABSTRACT Considering its strong, highly institutionalized two-party system, Venezuela was surely one of the least likely countries in Latin America to experience a party system breakdown and populist resurgence. That traditional party system nevertheless was founded on a mixture of corporatist and clientelist linkages to social actors that were unable to withstand the secular decline of the oil economy and several aborted attempts at market liberalization. Successive administrations led by the dominant parties failed to reverse the economic slide, with devastating consequences for the party system as a whole. The party system ultimately rested on insecure structural foundations; and when its social moorings crumbled in the 1990s, the populist movement of Hugo Chávez emerged to fill the political void. This populist resurgence both capitalized on and accelerated the institutional decomposition of the old order. [source] Up against the edge: invasive species as testbeds for basic questions about evolution in heterogeneous environmentsMOLECULAR ECOLOGY, Issue 21 2009ROBERT D. HOLT Yogi Berra is often credited, with having opined that ,prediction is very difficult, especially about the future'. There is no discipline for which this statement holds with more force than invasion biology, where it has been historically very challenging to predict the fate of introduced species (Williamson 2006). Some species after introduction quickly go extinct. Other relatively similar species may persist, but with little spread from their initial beachheads. Yet others can become aggressive invaders, with devastating consequences for native communities and ecosystems. This lack of predictability may of course sometimes reflect a simple lack of knowledge, both about key features of a species' basic biology, and about the environmental and community milieu in which invasion occurs (Williamson 2006). However, unpredictability may also arise from a fundamental fact about populations of living organisms , they almost always contain genetic variation, and so are not fixed entities responding to an environmental template, but instead labile in how they cope with the environment, over many spatial and temporal scales. Chance vicissitudes in the origination, maintenance and spatial organization of genetic variation could play a large role in generating the observed unpredictability in the fates of introduced species. The degree to which a particular introduced species becomes ,invasive', to the extent of coming to the attention of worried land managers, governmental officials and the public , may reflect in part its capacity for adaptive evolution across a wide range of environmental conditions. [source] Detooling The Language of the Master's House: The Case of Those "Nuclear Things"PEACE & CHANGE, Issue 2 2003Brien Hallett The tool of language helps to shape the argument and outcome of a political conflict in much the same way as the availability and selection of tools and materials affect the kind of house a builder will erect. The advocates of abolishing nuclear stockpiles down to absolute zero unwittingly have embraced the same terms or language tools as their opponents. "Banning the bomb" on the basis of its incredibly devastating consequences has failed in part because the antinuclearists have not disavowed the language that authenticates the alternative perspective of the bomb's incredible power. Along with their opponents, they have conjoined the word "nuclear" with the words "weapon" and "war" to create two formidable oxymora that have impaired greatly their ability to escape the lexical trap of the pronuclear mindset of power politics. In this article an argument is advanced for exposing and avoiding these oxymora and for suggesting some alternative terms in order that the abolitionists might reframe the debate in such a way that conventional political and military assumptions about nuclear power can be challenged radically. [source] Osteonecrosis of the Mandible or Maxilla Associated with the use of New Generation BisphosphonatesTHE LARYNGOSCOPE, Issue 1 2006Matthew C. Farrugia DO Objective: The use of bisphosphonates is well established for the treatment of patients with metastatic bone disease, osteoporosis, and Paget's disease. Osteonecrosis of the mandible or maxilla associated with the use of bisphosphonates is a newly described entity never before discussed in the otolaryngology literature. In this paper, we review a series of patients diagnosed with osteonecrosis, all treated with new generation bisphosphonates. Our objective is to inform and educate others, particularly otolaryngologists/head and neck surgeons, about this drug induced entity, a condition that should be recognized early to avoid potential devastating consequences. Study Design: Retrospective chart review of a series of patients from a tertiary referral center. Methods: Pathology reports of specimens submitted from either the mandible or maxilla were reviewed from the previous 12 months. Any patient diagnosed with osteonecrosis without evidence of metastatic disease at that site was included; those with a previous history of radiation therapy were excluded. Each patient's medical history and profile were reviewed. Results: Twenty-three patients were identified with osteonecrosis of the mandible or maxilla. All of these were associated with the use of new generation bisphosphonates: zolendronate (Zometa, Novartis), pamidronate (Aredia, Novartis), and alendronate (Fosamax, Merck). Eighteen patients with known bone metastases had been treated with the intravenous form, whereas five patients with either osteoporosis or Paget's disease were using oral therapy. Patients typically presented with a nonhealing lesion, often times the result of previous dental intervention. Although the majority of these patients were treated with conservative surgical debridement, we present a case requiring a near total maxillectomy. Conclusions: Drug induced osteonecrosis of the mandible or maxilla has been recently recognized as a sequelae of treatment with the new generation of bisphosphonates. Most patients can be treated with conservative surgical debridement and cessation of bisphosphonate therapy, whereas a few may require radical surgical intervention. Other recommendations include regimented prophylactic care with an assessment of dental status before the administration of bisphosphonates, avoidance of dental procedures, and close monitoring of oral hygiene. [source] CT31 HYPERBARIC OXYGEN IN POST-CARDIAC SURGERY STROKE PATIENTS , THE CHRISTCHURCH EXPERIENCEANZ JOURNAL OF SURGERY, Issue 2007A. J. Gibson Introduction Post-operative strokes occur in a small percentage of adult cardiac surgical patients and have devastating consequences for these patients. There is evidence to suggest that Cerebral Arterial Gas Embolism (CAGE) is an important aetiological factor in most of these cases. Hyperbaric Oxygen therapy (HBOT) is the administration of 100% oxygen at greater than atmospheric pressure. It is accepted as the definitive treatment for CAGE related to SCUBA diving accidents. The similarities between this and the pathophysiology of post cardiac-surgical strokes due to iatrogenic CAGE suggest that beneficial effects from HBOT may accrue to these patients. Purpose The purpose of this study is to review the experience of treating post cardiac-surgical stroke patients in our local hyperbaric oxygen facility, including their presentation, delay before treatment and outcomes. The current evidence base is reviewed. Method A retrospective case series analysis was conducted. Results Over a 10 year period, patients with post cardiac-surgical strokes and who presented within the first 48 hours were referred for HBOT, of whom 12 were treated. The neurological outcomes were excellent in all but one case who died. A review of the literature provides a rational basis for the potential benefits of HBOT in this scenario, but at present there is only limited clinical data to support its use. Conclusion The postulated mechanisms for the development of post cardiac-surgical strokes provide a sound theoretical basis for the suggestion that the use of HBOT is associated with improved outcomes. However there is no prospective data to support such a claim. Such a trial would be problematic and until more evidence is available, HBOT should be considered on a case by case basis. [source] Crush stenting of bifurcational left subclavian-vertebral artery stenosisCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 3 2004Ariel Roguin MD Abstract Left internal mammary artery (LIMA) has the best long-term patency in patients undergoing coronary artery bypass surgery. Stenosis of the proximal left subclavian artery (SA) may reduce flow to the LIMA, causing myocardial ischemia. We report a novel technique (crush stenting) for the treatment of a complex bifurcational left SA-vertebral artery (VA) stenosis in the presence of a patent LIMA bypass conduit. This technique limited plaque shifting, restored normal flow to all vessels, including the LIMA, and avoided devastating consequences of VA occlusion. Catheter Cardiovasc Interv 2004;62:393,395. © 2004 Wiley-Liss, Inc. [source] A Place Where I Can Let My Hair Down: from social club to cultural center in an urban Indian communityCITY & SOCIETY, Issue 1 2001Deborah Davis Jackson The "Riverton" Indian Center was established in the 1950s as large numbers of Native Americans migrated to the city from reservations around the Great Lakes and beyond, and underwent significant changes throughout the second half of the twentieth century. These changes, and the conflicts that resulted from them, were shaped by far larger political,economic and cultural forces: on the one hand, River ton's economy, along with the economies of many midsized cities in the Great Lakes region,was undergoing rapid deindustrialization with devastating consequences to local residents, including American Indians; on the other hand, social and cultural changes in the U.S., starting in the 1960s, made Native Americans,or at least a romanticized image of Native Americans,increasingly popular with non-Natives. These forces converged to create the three distinct phases in the Riverton Indian Center's history, each associated with a particular age cohort,a trajectory that might well be typical of deindustrializing cities in the Great Lakes region. [American Indians; community and identity; deindistrialivng cities; Upper Great Lakes region] [source] | ||||||||||||||||