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Forty-one Percent (forty-one + percent)
Selected AbstractsClinical Features and Prognosis of Nonepileptic Seizures in a Developing CountryEPILEPSIA, Issue 3 2001W. Silva Summary: ,Purpose: To determine the predictive value of clinical features and medical history in patients with nonepileptic seizures (NESs). Methods: One hundred sixty-one consecutive ictal video-EEGs were reviewed, and 17 patients with 41 NESs identified. NES diagnosis was defined as paroxysmal behavioral changes suggestive of epileptic seizures recorded during video-EEG without any electrographic ictal activity. Clinical features, age, sex, coexisting epilepsy, associated psychiatric disorder, social and economic factors, delay in reaching the diagnosis of NES, previous treatment, and correlation with outcome on follow-up were examined. Results: The study population included 70% female patients with a mean age of 33 years. Mean duration of NESs before diagnosis was 9 years. Forty-one percent had coexisting epilepsy. The most frequent NES clinical features were tonic,clonic mimicking movements and fear/anxiety/hyperventilation. The most common psychiatric diagnosis was conversion disorder and dependent and borderline personality disorder. Seventy-three percent of patients with pure NESs received antiepileptic drugs (AEDs), and 63.5% of this group received new AEDs. Fifty-nine percent of the patients received psychological/psychiatric therapy. At follow-up, 23.5% were free of NESs. Conclusions: All seizure-free patients had two good prognostic factors: having an independent lifestyle and the acceptance of the nonepileptic nature of the episodes. Video-EEG monitoring continues to be the diagnostic method to ensure accurate seizure classification. Establishing adequate health care programs to facilitate access to new technology in public hospitals as well as the implementation of continuous education programs for general practitioners and neurologists could eventually improve the diagnosis and treatment of patients with NESs. [source] Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horseEQUINE VETERINARY JOURNAL, Issue 4 2004O. M. CROWE Summary Reasons for performing study: Proximal suspensory desmitis (PSD) is diagnosed with increasing frequency in horses and radial pressure wave therapy (RPWT) is a widely used therapy for painful orthopaedic conditions in man and dogs. There are, however, few published data as to the outcome of its use in PSD. Objective: To evaluate the use of RPWT in the treatment of chronic or recurrent PSD in the horse, an injury which carries a poor prognosis for return to athletic function with conservative management alone. Hypothesis: RPWT and controlled exercise improves the prognosis of chronic or recurrent PSD in the horse when compared to previously published results of controlled exercise alone. Methods: The use of RPWT in the management of chronic or recurrent proximal suspensory desmitis (PSD) was evaluated in 65 horses. Diagnosis was based on response to local analgesia, ultrasonography and radiography. Horses were classified according to severity of ultrasonographic lesions, whether fore- or hindlimbs were affected, and duration of lameness prior to diagnosis. Horses were treated 3 times at 2-week intervals and followed a controlled exercise programme; they were reassessed clinically and ultrasonographically 10,12 weeks after diagnosis, when further exercise recommendations were made dependent upon the animal's progress. Results: Forty-one percent of horses with hindlimb lameness and 53% with forelimb lameness were nonlame and returned to full work 6 months after diagnosis. The prognosis was significantly affected by the ultrasonographic grade at the time of diagnosis and by ultrasonographic evidence of resolution of the lesion in hindlimb cases. Conclusions: These findings, when compared to previously published results of treatment using controlled exercise alone, suggest that RPWT improves the prognosis for PSD in the hindlimb. Potential relevance: RPWT is a useful treatment modality for chronic or recurrent PSD when combined with controlled exercise. Further studies are required on the effect of RPWT employing histology and biomechanics in order to fully evaluate its use on equine tissues. [source] Ulcerative colitis and clinical course: Results of a 5-year population-based follow-up study (the IBSEN study)INFLAMMATORY BOWEL DISEASES, Issue 7 2006Magne Henriksen MD Abstract Background: The majority of studies concerning the clinical course and prognosis in ulcerative colitis (UC) are old, retrospective in design, or hospital based. We aimed to identify clinical course and prognosis in a prospective, population-based follow-up study Materials and Methods: Patients diagnosed with inflammatory bowel disease (IBD) or possible IBD in southeastern Norway during the period 1990,1994 were followed prospectively for 5 years. The evaluation at 5 years included an interview, clinical examination, laboratory tests, and colonoscopy. Results: Of 843 patients diagnosed with IBD, 454 patients who had definite UC and for whom there were sufficient data for analysis were alive 5 years after inclusion in the study. The frequency of colectomy in this population was 7.5%. Forty-one percent of the patients were not taking any kind of medication for IBD at 5 years. Of the patients initially diagnosed with proctitis, 28% had progressed during the observation period, 10% to extensive colitis. The majority of the patients (57%) had no intestinal symptoms at 5 years, and only a minority (7%) had symptoms that interfered with everyday activities. Among the patients who underwent colonoscopy at the 5-year visit, symptoms were frequently reported in patients without macroscopic inflammation (44%). A relapse-free course was observed in 22% of the patients. A decrease in symptoms during the follow-up period was the most frequent course taken by the disease and was observed in 59% of the cases. The extent of disease was unrelated to symptoms at 5 years and also to relapse rate and course of disease during the 5-year period. Conclusions: The disease course and prognosis of UC appears better than previously described in the literature. The frequency of surgery was low, and only a minority of the patients had symptoms that interfered with their everyday activities 5 years after diagnosis. [source] Valuation of biodiversity effects from reduced pesticide useINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 2 2006Jesper S. Schou Abstract This study deals with the effects on biodiversity of pesticide-free buffer zones along field margins. Using choice modeling, the majority of respondents to a survey on pesticide use in the environment are willing to accept an increase in the price of bread if the survival of partridge chicks and the number of wild plants increase. The study identifies the need for further empirical work with respect to methodological validation, price estimation, and the use of survey results in policy analysis. In particular, the environmental effects of pesticide use are complex and, therefore, present difficult challenges when presenting information to lay people. Forty-one percent of respondents changed their responses regarding willingness to pay more for bread when references to pesticide use were introduced in the questionnaire. This indicates that scenarios depicting changes in pesticide use can be difficult to present to lay people in an economically rational and well-defined context. Thus, in the study of valuation related to changes in pesticide use, much attention should be devoted to the design and definition of the context. Furthermore, the effects of providing different background information, e.g., with or without the mention of pesticides, should be tested. [source] Prostate cancer in London: is the triadic clinical encounter the standard?INTERNATIONAL JOURNAL OF UROLOGICAL NURSING, Issue 2 2008Amanda Euesden Hughes Abstract It has been reported that men with prostate cancer in London were less satisfied with the service they received than patients with other cancers. Studies from the USA have looked at the experience of the prostate cancer couple. It has been established that the cancer couple have information needs and that when a clinical encounter is triadic in nature, these needs are more likely to be met and information is more likely to be retained. The aim of this study was to examine the clinic attendance patterns of men in London with prostate cancer (n = 200). A comparison group of women in London with breast cancer was identified (n = 200). Direct observation of the groups was performed, accompanied/unaccompanied (triadic/dyadic) attendance was recorded and demographic data were extracted from the clinical notes. Forty-one percent (81) of the women experienced their clinical encounter as a triad compared with 24% (48) of the prostate group who experienced their clinical encounter as a dyad between themselves and their health care provider (p < 0.05). In the first year of diagnosis, men with prostate cancer were more likely to experience a triadic encounter, but this was more evenly distributed throughout the cancer journey for women with breast cancer. There did not appear to be a correlation with marriage and triadic encounters for either group. Men with prostate cancer in this tertiary referral centre in London are less likely to experience a triadic clinical encounter than women with breast cancer. Further work is needed to establish a relationship between unmet informational needs of the prostate cancer couple and the high level of dissatisfaction in the prostate cancer population in London, but the nature of the dyadic encounter may play a part in this. [source] Desensitizing Agent Efficacy during Whitening in an At-Risk PopulationJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 1 2004RALPH H. LEONARD Jr. DDS. ABSTRACT Background: Nightguard vital bleaching (NGVB) has gained acceptance among dentists and patients as a simple and effective procedure to lighten discolored teeth. Although the efficacy and predictability of NGVB have been well established, it has been documented that patients undergoing the procedure may experience side effects such as tooth sensitivity (TS) and gingival irritation (GI). A previous NGVB study suggested that selected participants might benefit from a regimen of a desensitizing agent (DSA)to decrease or prevent TS during whitening. Purpose: The purpose of this study was to determine whether the daily use of an active DSA (UltraEZTM, Ultradent Products Inc., South Jordan, UT, USA) during NGVB would decrease TS in a population at risk for TS when compared with a placebo. Materials and Methods: Forty subjects participated in this single-blind randomized clinical trial. All participants had indicated that they had preexisting TS or other risk factors for TS during NGVB. To evaluate TS caused by the tray alone, participants wore custom-fitted maxillary whitening trays containing no DSA or whitening solution during week 1. Next, participants were randomly assigned to apply either the active DSA or placebo daily for 14 days in the trays for 30 minutes prior to whitening. The placebo was the same formulation as UltraEZ but without the desensitizing agents (3% potassium nitrate and 0.11% by weight fluoride ion). The bleaching solution was a 10% carbamide peroxide whitening solution (OpalescenceTM, Ultradent Inc.). Post treatment, participants were followed up for 1 week, during which time they used neither trays nor solutions. Throughout the study, participants completed a daily diary to record their perceptions of TS and the time spent wearing the tray with the whitening solution. Results: Forty-one percent of the active group had at least 1 day of TS during treatment compared with 78% of the placebo group. The difference was statistically significant (p= .027) using the two-tailed Fisher exact test. [source] Levels of autonomy of nurse practitioners in an acute care settingJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 10 2007CCRN (Clinical Nurse Manager), Corazon B. Cajulis DNP Abstract Purpose: The purpose of this descriptive study was to determine the level of autonomy of nurse practitioners (NPs) providing care to an adult patient population in an acute care setting. Data sources: Data were collected from 54 NPs in different specialty areas currently working in a large metropolitan hospital. The Dempster Practice Behaviors Scale was used to measure the autonomy of the NPs. Conclusions: The overall mean autonomy score of 117.37 (SD = 14.55) indicates a high level of autonomy of the NPs in this study. Forty-one percent of the participants had very high levels of autonomy, 31.5% had extremely high levels of autonomy, and 19% had moderate levels of autonomy. Demographic variables of age; years worked as an NP, as an RN, and at current job; highest educational level; basic nursing preparation; NP certification; and specialty had no statistically significant relationship with autonomy scores. Implications for practice: The results of this study provided preliminary evidence of the level of autonomy of NPs providing inpatient care to adult patients in an acute care setting. The findings could lead to future research on the impact of NP services on patient outcomes and clinical productivity in acute care settings. [source] MISSOURI RIVER FLOOD OF 1993: ROLE OF WOODY CORRIDOR WIDTH IN LEVEE PROTECTION,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 4 2003Stephen B. Allen ABSTRACT. We investigated the relationships between levee damage and woody corridor along a 353-mile segment of the Missouri River in Missouri during the flood of 1993. Results indicated that woody corridors between riverbanks and primary levees played a significant role in the reduction or prevention of flood related damage to levees. Forty-one percent of levee failures in this segment occurred in areas with no woody corridor, while 74 percent and 83 percent of failures occurred where woody corridor widths were less than 300 feet and less than 500 feet, respectively. Median failure lengths with a woody corridor present were 50.3 percent shorter than median failure lengths with no woody corridor present. Levees without failures had significantly wider median woody corridor widths than levees that failed. Eligibility for the Corps of Engineers levee maintenance program was not a significant factor in the reduction of levee damage. Discontinuities in woody corridors played a role in 27.5 percent of the levee failures in the study segment. Smaller segments of the river valley were studied to determine if geomorphic differences influenced variations in the protective value of woody corridors. [source] Evaluation of a Quality-of-Life Tool for Cats with Diabetes MellitusJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2010S.J.M. Niessen Background: Success in management of diabetes mellitus (DM) is defined as improvement of blood glucose concentrations and clinical signs. However, the psychological and social impact of DM and its daily treatment regimen on quality of life (QoL) of both animal and owner is uncertain. Hypothesis/Objectives: To design, validate, and apply a diabetic pet and owner-centered, individualized measure of impact of DM (DIAQoL-pet). Animals/Subjects: Two hundred and twenty-one owners of insulin-treated diabetic cats were recruited to complete the DIAQoL-pet. Methods: Discussions and pilot surveys with clinicians and owners of diabetic cats led to the design of 29 specific DM-associated QoL questions. Owners of diabetic cats completed the finalized survey. Each item was scored according to impact frequency and perceived importance. An item-weighted impact score (IWIS) for each item was calculated, as was an average-weighted impact score (AWIS) by averaging all IWISs. Principal component analysis and Cronbach's , calculation assessed the measure's reliability. Two overview questions measured overall QoL and diabetes-dependent QoL. Results: The DIAQoL-pet showed high reliability (Cronbach , 0.83). The AWIS was ,1.76 ± 2.4 (mean ± SD). Areas reported as most negatively impacting QoL included: "boarding difficulties" (IWIS ± SD: ,4.67 ± 5.3), "owner wanting more control" (,4.34 ± 4.7), "difficulties leaving cat with friends or family" (,4.21 ± 4.7), "worry" (,4.10 ± 3.9), "worry hypo" (,3.67 ± 3.5), "social life" (,3.48 ± 3.9), "costs" (,3.04 ± 3.8), and "work life" (,3.03 ± 3.7). Forty-one percent of owners believed their cat's life would be "a little better" without DM. Conclusions and Clinical Importance: The DIAQoL-pet proved robust and identified specific areas most negatively impacting on diabetic cats and their owners' QoL. This tool warrants further investigation for use in clinical or research settings. [source] | |||||||||||||