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Factor Leading (factor + leading)
Selected AbstractsRetaliatory Raids as an Accelerating Factor Leading to the Six -Day WarTHE HISTORIAN, Issue 3 2008Moshe Gat First page of article [source] A report from the international consensus on diagnosing and treating the infected diabetic foot,DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue S1 2004Benjamin A. Lipsky Chairman Abstract In persons with diabetes, foot infection, that is, invasion and multiplication of microorganisms in tissues accompanied by tissue destruction or a host inflammatory response, usually begins with skin trauma or ulceration 1. While most foot infections remain superficial, they can spread to subcutaneous tissues, including muscle, joints, and bone. Many diabetic foot ulcers eventuate in an amputation; infection plays a role in approximately 60% of cases 2,4. Neuropathy is the main factor leading to skin breaks, while arterial perfusion largely affects infection outcome. Among the factors predisposing diabetic patients to foot infections are ill-defined immunological perturbations 5, 6; foot anatomy may foster proximal spread of infection and ischemic necrosis 7, 8. Copyright © 2004 John Wiley & Sons, Ltd. [source] Prospects for the Euro: Why has it been so weak?ECONOMIC OUTLOOK, Issue 1 2001Stephen Hall In this article, Stephen Hall and Brian Henry consider the reasons for the Euro's weakness since its introduction and ask what are the likely prospects for a recovery to near-fundamental levels over the medium term. They conclude that the major factor leading to the currency's depreciation since 1999 has been a rise in the risk premium surrounding the Euro. A successful launch of Euro notes and coins may help to eliminate this premium. [source] Antimicrobial Susceptibility of Helicobacter pylori Strains in a Random Adult Swedish PopulationHELICOBACTER, Issue 4 2006Tom Storskrubb Abstract Background and Aim:, Antimicrobial resistance in Helicobacter pylori is a growing problem and has become an important factor leading to eradication failure. Information on antimicrobial susceptibility is important for selection of an optimum treatment regimen. The resistance rate in a random population has not been studied previously. Methods:, A random Swedish population sample (n = 3000, age 20,81 years) was surveyed using a mailed validated questionnaire assessing gastrointestinal symptoms (response rate of 74%). One-third of the responders was invited, in random order, and accepted an esophagogastroduodenoscopy with biopsies for H. pylori culture and histology. Subjects were not treated for their H. pylori infection but a minimum inhibitory concentration of metronidazole, clarithromycin, amoxicillin, and tetracycline for the H. pylori isolates (n = 333) was determined by agar dilution. Prescribed antibiotic in the area was recorded. Results:, Irrespective of symptomatology, 16.2% of the isolated H. pylori strains were resistant to metronidazole, 1.5% to clarithromycin, 0% to amoxicillin, and 0.3% to tetracycline. The antibiotic consumption was low from an international perspective. Conclusion:, The resistance to the antibiotics was lower than expected from patient sample studies, especially for clarithromycin, most probably due to a restrictive prescription policy in the area. Introduction of a test-and-treat strategy in Sweden would only marginally affect the usage of clarithromycin. [source] Clinical, laboratory and therapeutic aspects of platelet-type von Willebrand diseaseINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 2 2008M. FRANCHINI Summary Platelet-type von Willebrand disease (PT-VWD), or pseudo-VWD, is a rare inherited platelet disorder characterized by an increased affinity of the platelet membrane glycoprotein Ib, receptor for normal von Willebrand factor leading to characteristic platelet hyperaggregability. As PT-VWD shares most of the clinical and laboratory features of subtype 2B VWD, the differential diagnosis between these two inherited bleeding disorders requires either platelet-mixing or molecular genetic studies. In this review, the main clinical, laboratory and therapeutic characteristics of PT-VWD are concisely reported. [source] Thromboembolism in a patient with transient eosinophilia and thrombocytopeniaINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 4 2000Y. Sherer Summary A 24-year-old woman with an unremarkable medical history who developed bilateral deep venous thrombosis and pulmonary emboli is presented. Associated findings were severe eosinophilia and moderate thrombocytopenia. Since the major acquired and hereditary thrombogenic disorders were ruled out in this case (including antiphospholipid syndrome and heparin-induced thrombocytopenia), we believe that the severe eosinophilia per se could be the pro-coagulant factor leading to thrombosis and embolism in our patient. The role of eosinophilia in thrombosis is discussed. [source] Resting energy expenditure and body composition of Labrador Retrievers fed high fat and low fat dietsJOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 5-6 2006S. Yoo Summary A high dietary fat intake may be an important environmental factor leading to obesity in some animals. The mechanism could be either an increase in caloric intake and/or a decrease in energy expenditure. To test the hypothesis that high fat diets result in decreased resting energy expenditure (REE), we measured REE using indirect calorimetry in 10-adult intact male Labrador Retrievers, eating weight-maintenance high-fat (HF, 41% energy, average daily intake: 8018 ± 1247 kJ/day, mean ± SD) and low-fat (LF, 14% energy, average daily intake: 7331 ± 771 kJ/day) diets for a 30-day period. At the end of each dietary treatment, body composition measurements were performed using dual-energy X-ray absorptiometry. The mean ± SD REE was not different between diets (4940 ± 361 vs. 4861 ± 413 kJ/day on HF and LF diets respectively). Measurements of fat-free mass (FFM) and fat mass (FM) also did not differ between diets (FFM: 26.8 ± 2.3 kg vs. 26.3 ± 2.5 kg; FM: 3.0 ± 2.3 vs. 3.1 ± 1.5 kg on HF and LF diets respectively). In summary, using a whole body calorimeter, we found no evidence of a decrease in REE or a change in body composition on a HF diet compared with LF diet. [source] Dynamics of host plant use and species diversity in Polygonia butterflies (Nymphalidae)JOURNAL OF EVOLUTIONARY BIOLOGY, Issue 2 2006E. WEINGARTNER Abstract The ability of insects to utilize different host plants has been suggested to be a dynamic and transient phase. During or after this phase, species can shift to novel host plants or respecialize on ancestral ones. Expanding the range of host plants might also be a factor leading to higher levels of net speciation rates. In this paper, we have studied the possible importance of host plant range for diversification in the genus Polygonia (Nymphalidae, Nymphalini). We have compared species richness between sistergroups in order to find out if there are any differences in number of species between clades including species that utilize only the ancestral host plants (,urticalean rosids') and their sisterclades with a broader (or in some cases potentially broader) host plant repertoire. Four comparisons could be made, and although these are not all phylogenetically or statistically independent, all showed clades including butterfly species using other or additional host plants than the urticalean rosids to be more species-rich than their sisterclade restricted to the ancestral host plants. These results are consistent with the theory that expansions in host plant range are involved in the process of diversification in butterflies and other phytophagous insects, in line with the general theory that plasticity may drive speciation. [source] Indirect evidence from DNA sequence diversity for genetic degeneration of the Y-chromosome in dioecious species of the plant Silene: the SlY4/SlX4 and DD44-X/DD44-Y gene pairsJOURNAL OF EVOLUTIONARY BIOLOGY, Issue 2 2005V. LAPORTE Abstract The action of natural selection is expected to reduce the effective population size of a nonrecombining chromosome, and this is thought to be the chief factor leading to genetic degeneration of Y-chromosomes, which cease recombining during their evolution from ordinary chromosomes. Low effective population size of Y chromosomes can be tested by studying DNA sequence diversity of Y-linked genes. In the dioecious plant, Silene latifolia, which has sex chromosomes, one comparison (SlX1 vs. SlY1) indeed finds lower Y diversity compared with the homologous X-linked gene, and one Y-linked gene with no X-linked homologue has lower species-wide diversity than a homologous autosomal copy (SlAp3Y vs. SlAp3A). To test whether this is a general pattern for Y-linked genes, we studied two further recently described X and Y homologous gene pairs in samples from several populations of S. latifolia and S. dioica. Diversity is reduced for both Y-linked genes, compared with their X-linked homologues. Our new data are analysed to show that the low Y effective size cannot be explained by different levels of gene flow for the X vs. the Y chromosomes, either between populations or between these closely related species. Thus, all four Y-linked genes that have now been studied in these plants (the two studied here, and two previously studied genes, have low diversity). This supports other evidence for an ongoing degeneration process in these species. [source] Measurement of Brain and Spinal Cord Atrophy by Magnetic Resonance Imaging as a Tool to Monitor Multiple SclerosisJOURNAL OF NEUROIMAGING, Issue 2005FAAN, Rohit Bakshi MD ABSTRACT Evaluation of brain and spinal cord atrophy by magnetic resonance imaging (MRI) has become an increasingly important component of understanding the multiple sclerosis (MS) disease process. These destructive aspects of the disease develop early in the disease course. A growing body of data links brain and spinal cord atrophy to clinical impairment more closely than can be linked with conventional measures of overt lesions. Thus, irreversible tissue damage may be a key factor leading to disease progression. In this review, the authors present the proposed mechanisms leading to central nervous system (CNS) atrophy. They describe the available MRI-based techniques to measure regional and global atrophy of the brain and spinal cord. They compare the rate of atrophy among MS phenotypes and summarize the emerging data linking atrophy to neurological and neuropsychological impairment. Finally, they discuss the effect of disease-modifying immunotherapies on the rate of CNS atrophy in patients with MS. Future research to clarify the etiology and pathophysiology of brain and spinal cord atrophy should provide new targets for therapeutic development. [source] Assessing a novel microfluidic interface for shotgun proteome analysesJOURNAL OF SEPARATION SCIENCE, JSS, Issue 10 2007An Staes Abstract Microfluidic interfaces coupled to ESI mass spectrometers hold great potential for proteomics as they have been shown to augment the overall sensitivity of measurements and require only a minimum of operator manipulations as compared to conventional nano-LC interfaces. Here, we evaluated a new type of HPLC-Chips holding larger enrichment columns (thus an increased sample loading capacity) for gel-free proteome studies. A tryptic digest of a human T-cell proteome was fractionated by strong cation exchange chromatography and selected fractions were analyzed by MS/MS on an IT mass spectrometer using both the new HPLC-Chip as well as a conventional nano-LC-MS/MS interface. Our results indicate that the HPLC-Chip is capable of handling very complex peptide mixtures and, in fact, leads to the identification of more peptides and proteins as compared to when a conventional interface was used. The HPLC-Chip preferentially produced doubly charged tryptic peptides. We further show that MS/MS spectra of doubly charged tryptic peptide ions are more readily identified by MASCOT as compared to those from triply charged precursors and thus argue that besides the improved chromatographic conditions provided by the HPLC-Chip, its peptide charging profile might be a secondary factor leading to an increased proteome coverage. [source] Alcohol is the Main Factor in Excess Traffic Accident Fatalities in FranceALCOHOLISM, Issue 12 2002Michel Reynaud Background The aim of this study was to better evaluate the role of alcohol drinking in fatalities linked to road traffic accidents. Methods The data of accidents were collected by a French official agency from police records, including many variables, among which was a blood alcohol test. They were analyzed in a descriptive way and toward a logistic regression. This exhaustive database comprised all of the 500,961 accidents with casualties that involved less than three vehicles (28,506 fatal accidents) recorded in France during a 52 month period (September 1995 to December 1999). The results of the alcohol tests were known in 78.7 of the drivers. Results The blood alcohol concentration was over the legal limit (0.50 g/L in France) in 9.8% of the accidents with casualties overall. Considering only fatal accidents, the rate of positive alcohol test in drivers was approximately 31.5%. This rate varied depending on the period and the type of accident, raising up to 71.2% in single-vehicle accidents (loss of control) at night during the weekend. The percentage of positive alcohol tests also dramatically increased following the number of fatalities per accident (87.5% in single-vehicle accidents during weekend nights involving three or more killed). The logistic regression in single-vehicle accident shows that the higher odds ratios concern the positive blood alcohol test (OR = 4.19), clearly overwhelming the other precipitating factors of accidents (age of driver, meteorological conditions, time of day, and other factors). Conclusions Drinking alcohol before driving is a well known factor of accidents. We clearly demonstrate here that it is the main factor leading to deaths linked to road traffic accidents in France. The results are strengthened, and some analyses are allowed, by the exceptional features of our database. The authors emphasize the need for prevention measures. [source] Interspecies differences in hepatic Ca2+ -ATPase activity and the effect of cold preservation on porcine liver Ca2+ -ATPase functionLIVER TRANSPLANTATION, Issue 2 2001Piotr K. Janicki MD The accumulation of intracellular calcium ([Ca2+]i) caused by ischemia-reperfusion during liver transplantation has been implicated as a factor leading to primary graft nonfunction. Plasma membrane (PM) and endoplasmic reticulum (ER) Ca2+ -adenosinetriphosphatases (ATPases) are the primary transporters that maintain [Ca2+]i homeostasis in the liver. We hypothesized that the porcine liver is better than the rat liver as a model for the study of human liver Ca2+ -ATPase activity. We also hypothesized that cold preservation would depress Ca2+ -ATPase activity in the porcine liver. Pig and rat livers were harvested, and human liver samples were obtained from surgical resection specimens. All were preserved with University of Wisconsin solution, and porcine livers were also preserved on ice for 2 to 18 hours. Ca2+ -ATPase activity was measured after incubation with 45Ca2+ and adenosine triphosphate in the presence of specific Ca2+ -ATPase inhibitors. Porcine PM and ER Ca2+ -ATPase activities were 0.47 ± 0.03 and 1.57 ± 0.10 nmol of Ca2+/mg of protein/min, respectively. This was not significantly different from human liver, whereas rat liver was significantly greater at 2.60 ± 0.03 and 9.2 ± 0.9 nmol of Ca2+/mg of protein/min, respectively. We conclude that the Ca2+ -ATPase activity in the pig liver is equivalent to that of human liver, and thus, the pig liver is a better model than the rat liver. Cold preservation studies showed a significant decrease in porcine hepatic PM Ca2+ -ATPase activity after 4 hours of storage and near-total inhibition after 12 hours. Porcine hepatic ER Ca2+ -ATPase activity showed a 45% decrease in activity by 12 hours and a 69% decrease by 18 hours. We conclude that cold ischemia at clinically relevant times depresses PM Ca2+ -ATPase more than ER Ca2+ -ATPase activity in pig liver homogenates. [source] Ternary miscibility in blends of three polymers with balanced binary interactionsPOLYMER ENGINEERING & SCIENCE, Issue 3 2003E. M. Woo This study demonstrates and discusses ternary miscibility in a three-polymer blend system based on balanced binary interactions. A truly miscible ternary blend comprising poly(,-caprolactone) (PCL), poly(benzyl methacrylate) (PBzMA), and poly(vinyl methyl ether) (PVME), was discovered and reported. Miscibility with phase homogeneity (excluding the PCL crystalline domain) in a wide composition range has been demonstrated using criteria of thermal transition behavior, cloud point, and microscopy characterization. At ambient temperature, the three-polymer ternary system is completely miscible within the entire composition range (i.e., no immiscibility loop). However, at slightly elevated temperatures above the ambient. phase separation readily occurred in this originally miscible ternary blend. A quite low "lower critical solution temperature" (LCST) near 75°C was found for the ternary blend, which is much lower than any of those for the binary pairs. Balanced interactions with no offsetting ,, among the three binary pairs were a key factor leading to a ternary miscible system. [source] REVIEW ARTICLE: Clinical Relevance of Oxidative Stress in Male Factor Infertility: An UpdateAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 1 2008Ashok Agarwal Male factor has been considered a major contributory factor to infertility. Along with the conventional causes for male infertility such as varicocele, cryptorchidism, infections, obstructive lesions, cystic fibrosis, trauma, and tumors, a new, yet important cause has been identified: oxidative stress. Oxidative stress (OS) is a result of the imbalance between reactive oxygen species (ROS) and antioxidants in the body, which can lead to sperm damage, deformity and eventually male infertility. This involves peroxidative damage to sperm membrane and DNA fragmentation at both nuclear and mitochondrial levels. OS has been implicated as the major etiological factor leading to sperm DNA damage. OS-induced DNA damage can lead to abnormalities in the offspring including childhood cancer and achondroplasia. In this article, we discuss the need of ROS in normal sperm physiology, the mechanism of production of ROS and its pathophysiology in relation to male reproductive system. The benefits of incorporating antioxidants in clinical and experimental settings have been enumerated. We also highlight the emerging concept of utilizing OS as a method of contraception and the potential problems associated with it. [source] Boreal winter predictions with the GEOS-2 GCM: The role of boundary forcing and initial conditionsTHE QUARTERLY JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY, Issue 567 2000Yehui Chang Abstract Ensembles of atmospheric General Circulation Model (GCM) seasonal forecasts and long-term simulations are analysed to assess the controlling influences of boundary forcing and memory of the initial conditions. Both the forecasts and simulations are carried out with version 2 of the Goddard Earth Observing System (GEOS-2) GCM forced with observed sea surface temperatures (SSTs). While much of the focus is on the seasonal time-scale (January-March; 1981,95) and the Pacific North American (PNA) region, we also present results for other regions, shorter time-scales, and other known modes of variability in the northern hemisphere extratropics. Forecasts of indices of some of the key large-scale modes of variability show that there is considerable variability in skill between different regions of the northern hemisphere. The eastern North Atlantic region has the poorest long-lead forecast skill, showing no skill beyond about 10 days. Skilful seasonal forecasts are primarily confined to the wave-like El Niño Southern Oscillation (ENSO) response emanating from the tropical Pacific. In the northern hemisphere, this is similar to the well-known PNA pattern. Memory of the initial conditions is the major factor leading to skilful extratropical forecasts of lead time less than one month, while boundary forcing is the dominant factor at the seasonal time-scale. Boundary forcing contributes to skilful forecasts at sub-seasonal time-scales only over the PNA region. The GEOS-2 GCM produces average signal-to-noise ratios which are less than 1.0 everywhere in the extra-tropics, except for the subtropical Pacific where they approach 1.5. An assessment of the sampling distribution of the forecasts suggests the model's ENSO response is very likely too weak. These results show some sensitivity to the uncertainties in the estimates of the SST forcing fields. In the North Pacific region, the sensitivity to SST forcing manifests itself primarily as changes in the variability of the PNA response, underscoring the need for an ensemble approach to the seasonal-prediction problem. [source] Population pharmacokinetic analysis of varenicline in adult smokersBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 5 2009Patanjali Ravva WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT? , Several clinical pharmacology studies have characterized the pharmacokinetics of varenicline in young adult and elderly smokers and subjects with impaired renal function. , Varenicline pharmacokinetics is linear over the recommended dose range. , Varenicline total clearance is linearly related to its renal clearance. , Both are progressively reduced as renal function declines, which results in a progressive increase in varenicline systemic exposure and prolonged half-life. WHAT THIS STUDY ADDS? , This work provides an integrated model-based analysis of varenicline pharmacokinetics across multiple studies in the target patient population. , The model describes the impact of patient-specific covariates, such as renal function, and provides a rationale for dose adjustment. , The resulting model also provides a means to predict individual-specific drug exposures to clinical responses in subsequent analyses. AIMS To characterize the population pharmacokinetics of varenicline and identify factors leading to its exposure variability in adult smokers. METHODS Data were pooled from nine clinical studies consisting of 1878 subjects. Models were developed to describe concentration,time profiles across individuals. Covariates were assessed using a full model approach; parameters and bootstrap 95% confidence intervals (CI) were estimated using nonlinear mixed effects modelling. RESULTS A two-compartment model with first-order absorption and elimination best described varenicline pharmacokinetics. The final population parameter estimates (95% CI) were: CL/F, 10.4 l h,1 (10.2, 10.6); V2/F, 337 l (309, 364); V3/F, 78.1 l (61.9, 98.9); Q/F, 2.08 l h,1 (1.39, 3.79); Ka, 1.69 h,1 (1.27, 2.00); and Alag, 0.43 h (0.37, 0.46). Random interindividual variances were estimated for Ka[70% coefficient of variation (CV)], CL/F (25% CV), and V2/F (50% CV) using a block covariance matrix. Fixed effect parameters were precisely estimated [most with % relative standard error < 10 and all with % relative standard error < 25], and a visual predictive check indicated adequate model performance. CL/F decreased from 10.4 l h,1 for a typical subject with normal renal function (CLcr = 100 ml min,1) to 4.4 l h,1 for a typical subject with severe renal impairment (CLcr = 20 ml min,1), which corresponds to a 2.4-fold increase in daily steady-state exposure. Bodyweight was the primary predictor of variability in volume of distribution. After accounting for renal function, there was no apparent effect of age, gender or race on varenicline pharmacokinetics. CONCLUSIONS Renal function is the clinically important factor leading to interindividual variability in varenicline exposure. A dose reduction to 1 mg day,1, which is half the recommended dose, is indicated for subjects with severe renal impairment. [source] Psychiatric and psychosomatic symptoms are increasing problems among Swedish schoolchildrenACTA PAEDIATRICA, Issue 8 2006Åse Victorin CederquistArticle first published online: 29 MAR 200 Abstract Paediatricians and other professionals in Sweden note that the amount of children with psychiatric and psychosomatic symptoms is growing in number. Suicide attempts among the young (15,24 y) increased by more than 30% from 1998,2003. The Swedish National Board for Health and Welfare's 2004 guidelines for school healthcare shed light on this increasing problem among schoolchildren. An article in this issue of Acta Paediatrica, "Living conditions and psychosomatic complaints in Swedish schoolchildren", analyses economic stress as a causative factor leading to psychosomatic symptoms such as headache, abdominal pain and difficulty in falling asleep. Living conditions, however, most likely include other factors related to our modern and ever-changing society that also have an impact on the growing child. Conclusion: Psychiatric health is changing for the worse among Swedish schoolchildren. The cause is multifactorial. Economic stress is one factor, but there are also other possible causes related to modern society that correlate to the increase of psychosomatic problems among schoolchildren. Three major problems are among those suspected: impaired education and deficient working environment in Swedish schools, a general lack of adult contact and guidance, and excessive computer and TV use. [source] Self-reported prevalence and awareness of metabolic syndrome: findings from SHIELDINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2008S. J. Lewis Summary Purpose:, This study assessed awareness of metabolic syndrome and evaluated health knowledge, attitudes and behaviours of respondents at risk. Methods:, Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD), a longitudinal US population-based survey initiated in 2004, included respondents, , 18 years of age, reporting a diagnosis of metabolic syndrome. Prevalence of metabolic syndrome was compared in SHIELD and National Health and Nutrition Examination Survey (NHANES) 1999,2002 survey. The proportion of SHIELD respondents who had heard of and/or understood metabolic syndrome was estimated. Respondents at high risk for metabolic syndrome were stratified into attitude-behaviour categories of ,Already Doing It', ,I Know I Should' and ,Don't Bother Me' and differences in attitudes and behaviours were evaluated with chi-square tests. Results:, Prevalence of reported metabolic syndrome was 0.6% in SHIELD screening questionnaire respondents (n = 211,097) vs. 25.9% in NHANES (n = 10,780). Less than 15% of SHIELD baseline questionnaire respondents (n = 22,001) had heard of or understood metabolic syndrome. Attitudes toward health status were more favourable in the ,Doing' group (27% reported fair/poor health) compared with those in the ,Should' (38%) and ,Don't' (54%) groups (p < 0.0001). The ,Don't' group was most likely to prefer medications to lifestyle change (13% vs. 2,4%) compared with ,Should' and ,Doing' groups (p < 0.0001). More ,Doing' respondents (79%) than ,Should' (59%) and ,Don't' (48%) respondents reported exercising regularly (p < 0.0001). Conclusions:, The lack of knowledge about metabolic syndrome reported in SHIELD indicates limited penetration of this concept into public awareness. With behaviour categories, respondents who report healthy attitudes are more likely to embrace lifestyle changes, while respondents who do not care may be more difficult to treat. [source] Quality of life and depression of people living with type 2 diabetes mellitus and those at low and high risk for type 2 diabetes: findings from the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD)INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2008S. Grandy Summary Objectives:, This study compared health-related quality of life (HRQoL) and depression among individuals with type 2 diabetes mellitus (T2D) and those at low or high risk for T2D. Methods:, Respondents in a population-based US 2004 survey reported whether they had T2D (n = 3530) or risk factors for T2D [abdominal obesity, body mass index (BMI) , 28 kg/m2, dyslipidaemia, hypertension and history of cardiovascular disease]. Respondents without T2D were stratified into low risk (0,2 risk factors, n = 5335) and high risk (3,5 risk factors, n = 5051). SF-12 version 2 (SF-12) and Patient Health Questionnaire (PHQ)-9 were used to measure HRQoL and depression. Mean scores were compared across the three groups using analysis of variance. Linear regression identified factors associated with SF-12 Physical and Mental Component Summary scores (PCS and MCS), adjusting for age, gender, race, income, geographic region, household size, BMI and group. Results:, Respondents were mostly women (60%) with mean age of 54 years. Mean PCS scores for T2D and high risk (39.5 and 41.7, respectively) were significantly lower than for low risk (50.6, p < 0.001). After adjustment, high-risk and T2D groups were associated with lower PCS and MCS scores compared with low risk group (p < 0.05). Mean PHQ-9 scores and per cent with moderate-to-severe depression were significantly higher for T2D and high risk than for low risk (p < 0.01). Conclusions:, Health-related quality of life and depression scores in T2D were similar to those at high risk, and indicated significant decrements in physical health and greater depression compared with low-risk respondents. [source] Mortality dynamics and population regulation in Bemisia tabaciENTOMOLOGIA EXPERIMENTALIS ET APPLICATA, Issue 2 2005Steven E. Naranjo Abstract Natural mortality is an important determinant of the population dynamics of a species, and an understanding of mortality forces should aid in the development of better management strategies for insect pests. An in situ, observational method was used to construct cohort-based life tables for Bemisia tabaci (Gennadius) Biotype B (Homoptera: Aleyrodidae) over 14 generations on cotton in central Arizona, USA, from 1997 to 1999. In descending order, median marginal rates of mortality were highest for predation, dislodgment, unknown causes, egg inviability, and parasitism. The highest mortality occurred during the 4th nymphal stadium, and the median rate of immature survival over 14 generations was 6.6%. Predation during the 4th nymphal stadium was the primary key factor. Irreplaceable mortality was highest for predation and dislodgment, with the absence of these mortality factors leading to the greatest increases in estimated net reproduction. There was little evidence of direct or delayed density-dependence for any mortality factor. Wind, rainfall, and predator densities were associated with dislodgment, and rates of predation were related to densities of Geocoris spp., Orius tristicolor (White), Chrysoperla carnea s.l. Stephens, and Lygus hesperus Knight. Simulations suggest that immigration and emigration play important roles in site-specific dynamics by explaining departures from observed population trajectories based solely on endogenous reproduction and mortality. By a direct measurement of these mortality factors and indirect evidence of adult movement, we conclude that efficient pest management may be best accomplished by fostering greater mortality during the 4th stadium, largely through a conservation of predators and by managing immigrating adult populations at their sources. [source] Pharmacokinetics of factors IX, recombinant human activated factor VII and factor XIIIHAEMOPHILIA, Issue 2006M.-C. POON Summary., There is now a volume of literature on the pharmacokinetics (PK) of coagulation factor concentrates, although the majority is on factor VIII (FVIII) and factor IX (FIX). PK of FIX and FVIII are different with FIX having a larger volume of distribution (Vdss), higher elimination clearance (CL), longer mean resident time (MRT) and longer terminal half-life (T1/2,,). Factor IX in vivo recovery (IVR) is also much shorter possibly due to reversible binding of FIX to the endothelium and possibly to platelets. There is considerable FIX PK variability between products (particularly between plasma-derived FIX and recombinant FIX), and between individuals. Important inter-individual factors leading to PK variability include age and body weight because plasma volume as a fraction of body weight decreases with increasing weight and hence age. Thus, IVR increases with body weight and hence age and is consequently lower in children than in adults. Absolute Vdss and CL increase linearly with body weight and age in children and adolescents, becoming stable in adults with more stable weight. Inter-individual variability also likely applies to other clotting factors, particularly to recombinant activated FVII (rFVIIa) but likely also to the less well studied factor XIII (FXIII). The former is known to have an extremely short T1/2,,, large Vdss, high CL, short MRT, whereas the latter has an extremely long T1/2,,, large Vdss, short CL and long MRT. Both are discussed in this article. Understanding of PK of specific clotting factors in individual patients is important in order to make decisions regarding appropriate dosage and dosage intervals to treat patients, and to allow by means of computer modelling the determination of dosage to achieve target trough level at various dosing intervals for patients undergoing prophylaxis. [source] Risk factors for oral hairy leukoplakia in HIV-infected adults of BrazilJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 6 2006Mariela Dutra Gontijo Moura Background:, Oral hairy leukoplakia (OHL) may be an indicator of the progression of Human Immunodeficiency Virus (HIV)-induced immuno-depression, and the evaluation of risk factors leading to OHL is important in the management of these HIV-infected patients. However, there are few studies that analyze risk factors leading to OHL in the Brazilian population. The aim of this case,control study is to present data about prevalence rates and risk factors leading to OHL in a sample of HIV-infected adults in Brazil. Methods:, This case,control study included 111 HIV-infected patients treated at a clinic for sexually transmitted diseases and HIV. In the initial examinations with dentists, variables were collected from all patients. Diagnosis of OHL was performed in accordance with the International Classification System and cytological features. The Fisher and the chi-squared tests were used for statistical analysis. The proportional prevalence and odds ratio were estimated. Results:, Outcome presented a positive, statistically significant association among the presence of OHL and viral load of 3000 copies/,l or greater (P = 0.0001; odds ratio (OR) = 5.8), presence of oral candidiasis (P = 0.0000; OR = 11.1), previous use of fluconazole (P = 0.0000; OR = 24.6), and use of systemic acyclovir (P = 0.032; OR = 4.3). Antiretroviral medication presented a negative, statistically significant association with the presence of OHL (P = 0.002; OR = 8.4). Conclusions:, Prevalence of OHL was 28.8%. Viral load, oral candidiasis, previous use of fluconazole, and systemic acyclovir were determined to be risk factors for OHL. Antiretroviral medication proved to be protective against the development of OHL. [source] Indications and patient selection for cytoreductive surgery and perioperative intraperitoneal chemotherapy,JOURNAL OF SURGICAL ONCOLOGY, Issue 4 2009Santiago González-Moreno MD Abstract Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy has provided unprecedented results in the management of peritoneal-based neoplasms. Prognostic factors leading to a survival advantage when this treatment modality is employed have been identified. A steep learning curve has been described as well. Therefore, knowledgeable indication setting and proper selection of patients to whom this combined treatment can be offered is warranted in order to obtain the best results at the lowest possible toxicity. J. Surg. Oncol. 2009;100:287,292. © 2009 Wiley-Liss, Inc. [source] Polyomavirus Allograft Nephropathy: Sequential Assessment of Histologic Viral Load, Tubulitis, and Graft Function Following Changes in ImmunosuppressionAMERICAN JOURNAL OF TRANSPLANTATION, Issue 11 2003Betul Celik Our initial cases of polyoma virus allograft nephropathy (PVAN) received pulse steroids due to anxiety about concomitant acute rejection triggered by the presence of tubulitis. However, our current policy is to reduce immunosuppression in all cases. The aim of this study was to determine whether clinical follow-up in these patient categories shows any differences in: (a) histologic viral load, (b) grade of tubulitis, and (c) graft function. Reduced viral load assessed within 8 weeks was seen in 4/20 (20.0%) biopsies treated initially by increased immunosuppression, compared to 15/19 (83.3%) biopsies treated with reduced immunosuppression (p = 0.001, Fisher's exact test). Yet, >70% reversal of the rise in serum creatinine occurred in only 3/19 (15.8%) and 1/19 (5.3%) patients, respectively, in these two groups. Improved tubulitis was seen in 11/20 (55%) of biopsies treated with steroids, despite the lack of beneficial effect on serum creatinine in 12/19 (63.1%) instances. In biopsies not treated with any change in immunosuppression, the serum creatinine remained stable in 1/5 (20%) and worsened in 4/5 (80%) biopsies. These data demonstrate that in biopsies with PVAN and tubulitis, reduced immunosuppression is more effective in lowering viral load than steroid therapy. Lack of parallelism between viral load, tubulitis grade, and serum creatinine illustrates a complex interplay of viral and alloimmune factors leading to graft injury. [source] | ||||||||||||||||