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Frequent Problem (frequent + problem)
Selected AbstractsSimultaneous Optimization of Luminance and Color Chromaticity of Phosphors Using a Nondominated Sorting Genetic AlgorithmADVANCED FUNCTIONAL MATERIALS, Issue 11 2010Asish Kumar Sharma Abstract Acquiring materials that simultaneously meet two or more conflicting requirements is very difficult. For instance, a situation wherein the color chromaticity and photoluminescence (PL) intensity of phosphors conflict with one another is a frequent problem. Therefore, identification of a good phosphor that simultaneously exhibits both desirable PL intensity and color chromaticity is a challenge. A high-throughput synthesis and characterization strategy that was reinforced by a nondominated sorting genetic algorithm (NSGA)-based optimization process was employed to simultaneously optimize both the PL intensity and color chromaticity of a MgO,ZnO,SrO,CaO,BaO,Al2O3,Ga2O3,MnO system. NSGA operations, such as Pareto sorting and niche sharing, and the ensuing high-throughput synthesis and characterization resulted in identification of promising green phosphors, i.e., Mn2+ -doped AB2O4 (A,=,alkali earth, B,=,Al and Ga) spinel solid solutions, for use in either plasma display panels or cold cathode fluorescent lamps. [source] Acute kidney injury in cirrhosis,HEPATOLOGY, Issue 6 2008Guadalupe Garcia-Tsao Acute renal failure (ARF), recently renamed acute kidney injury (AKI), is a relatively frequent problem, occurring in approximately 20% of hospitalized patients with cirrhosis. Although serum creatinine may underestimate the degree of renal dysfunction in cirrhosis, measures to diagnose and treat AKI should be made in patients in whom serum creatinine rises abruptly by 0.3 mg/dL or more (,26.4 ,mol/L) or increases by 150% or more (1.5-fold) from baseline. The most common causes of ARF (the term is used interchangeably with AKI) in cirrhosis are prerenal azotemia (volume-responsive prerenal AKI), acute tubular necrosis, and hepatorenal syndrome (HRS), a functional type of prerenal AKI exclusive of cirrhosis that does not respond to volume repletion. Because of the progressive vasodilatory state of cirrhosis that leads to relative hypovolemia and decreased renal blood flow, patients with decompensated cirrhosis are very susceptible to developing AKI with events associated with a decrease in effective arterial blood volume. HRS can occur spontaneously but is more frequently precipitated by events that worsen vasodilatation, such as spontaneous bacterial peritonitis. Conclusion: Specific therapies of AKI depend on the most likely cause and mechanism. Vasoconstrictors are useful bridging therapies in HRS. Ultimately, liver transplantation is indicated in otherwise reasonable candidates in whom AKI does not resolve with specific therapy. (HEPATOLOGY 2008;48:2064-2077.) [source] Infection probability score, APACHE II and KARNOFSKY scoring systems as predictors of infection onset in haematology,oncology patientsJOURNAL OF CLINICAL NURSING, Issue 11-12 2010Eleni Apostolopolou Aim., To assess the predictive power of three systems: Infection Probability Score, APACHE II and KARNOFSKY score to the onset of healthcare-associated infections in haematology,oncology patients. Background., The high incidence of healthcare-associated infections is a frequent problem in haematology,oncology patients that affects morbidity and mortality of these patients. Design., A retrospective surveillance survey. Method., The survey was conducted for seven months in the haematology unit of a general hospital in Greece to assess the predictive power of Infection Probability Score, APACHE II and KARNOFSKY score to the onset of healthcare-associated infections. The sample consisted of 102 hospitalised patients. The diagnosis of healthcare-associated infections was based on the definitions proposed by CDC. Results., Among the participants, 53 (52%) were males and 49 (48%) were females with a mean age of 53·30 (SD 18·59) years old (range, 17,85 years). The incidence density of healthcare-associated infections (the number of new cases of healthcare-associated infections per 1000 patient-days) was 21·8 infections per 1000 patient-days. Among the 102 patients, healthcare-associated infections occurred in 32 (31·4%) patients who had a total of 48 healthcare-associated infections (47·5%). Among the 38 patients with neutropenia, 26 (68·4%) had more than one healthcare-associated infection. Of the 48 detected healthcare-associated infections, the most frequent type was blood-stream infection (n = 17, 35·4%), followed by Clostridium difficile infection (n = 11, 22·9%) and respiratory tract infection (n = 8, 3·4%). The best cut-off value of Infection Probability Score (IPS) for the prediction of a healthcare-associated infection was 10 with sensitivity of 59·4% and specificity of 74·3%. Conclusions., Between the three different prognostic scoring systems, IPS had the best sensitivity in predicting healthcare-associated infections. Relevance to clinical practice., IPS is an effective tool and should be used from nurses for the early detection of haematology,oncology patients who are susceptible to the onset of a healthcare-associated infection. [source] Vulval vestibulitis: a common cause of dyspareunia?BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2005Pat Munday The prevalence of vulval vestibulitis was evaluated in a prospective observational study. Four hundred women from West Hertfordshire, 100 each from community family planning, antenatal, general practice and genitourinary clinics were investigated. Participants completed a questionnaire and were examined for vulval erythema and point tenderness. An algesiometer was also used to evaluate tenderness. The prevalence of vestibulitis varied from 2.9% to 9.8% depending on the stringency of diagnostic criteria and the method of ascertaining pain. Vulval vestibulitis cannot be accurately defined by current criteria, but superficial dyspareunia appears to be a frequent problem in the community in women consulting for unrelated matters. [source] Effect of oral naloxone hydrochloride on gastrointestinal transit in premature infants treated with morphineACTA PAEDIATRICA, Issue 3 2009Ranaa Akkawi Abstract Background: Opioids are common drugs for pain treatment in preterm newborn infants, in spite of several adverse effects. Constipation is a frequent problem when opioids are used in both adults and neonates. Although several studies indicate that the oral administration of naloxone hydrochloride (NH) improves intestinal motility during opioid therapy, there is still a lack of evidence in newborns. Aim: The aim of this study was to assess the efficacy of NH against reduced intestinal motility during opioid treatment. Methods: A retrospective cohort study was performed. We analysed the medical records of fifteen infants (Group 1) treated with continuous morphine (MO) infusion and fourteen infants (Group 2) treated with both oral NH (3 ,g/kg 4 times daily) and MO. Results: There was no statistically significant difference in the total MO dose. Infants treated both with NH and MO had a tendency to improve their mean stool frequency/day. A statistically significant improvement was observed in the mean total food intake (mL/kg/day) of the infants treated with NH (p = 0.014). No difference in the mean food retention between the two groups was observed. Conclusion: Orally administrated NH seems to improve intestinal motility resulting in increased food intake/day and improved stool frequency/day in premature newborn infants treated with MO. Further studies are needed to corroborate these findings. [source] Drug allergy claims in children: from self-reporting to confirmed diagnosisCLINICAL & EXPERIMENTAL ALLERGY, Issue 1 2008E. Rebelo Gomes Summary Background Poorly documented self-reported drug allergy (DAll) is a frequent problem in daily clinical practice and has a considerable impact on prescription choices. The diagnostic work-up of drug hypersensitivity (DHs) allows a better classification of the reactions and provides patients with more reliable information and recommendations for future treatments. Objective To assess the prevalence of self-reported adverse drug reactions (ADRs) and DAll in a paediatric population and to investigate children reporting suspected DAll in order to achieve a firm diagnosis. Design The first phase was based on a cross-sectional survey assessing the life occurrence of ADRs and self-reported DAll carried out at the outpatient clinic of a paediatric hospital. The second phase was based on the diagnostic work-up in children with parent-reported DAll, including detailed anamnesis and in vitro and in vivo investigations (skin and provocation tests). Participants One thousand four hundred and twenty-six parents responded to the initial survey. Sixty of the 67 patients with reported DAll were evaluated at the allergy clinic. Results The prevalences of self-reported ADRs and DAll were 10.2% and 6.0%, respectively. Most of the suspected allergic reactions were non-immediate cutaneous events attributable to ,-lactam antibiotics and occurred in very young children. Thirty-nine of the 60 patients consulting for evaluation had a plausible clinical history and were recommended further investigation. DHs was diagnosed in three children only, based on positive responses in skin (n=1) and oral provocation (n=2) tests. Conclusion ADRs are frequently reported in children, and many children are classified as having a DAll. After complete evaluation, only a few of these reactions can be attributed to DHs and DAll. Most of the patients (94% in this study) could actually tolerate the initially suspected drug. [source] Paediatric poisonings treated in one Finnish main university hospital between 2002 and 2006ACTA PAEDIATRICA, Issue 6 2008Juho E Kivistö Abstract Aim: Acute poisonings are a major cause of morbidity among children. This study aims to describe the incidence and nature of emergency visits for acute paediatric poisoning among Finnish children. Methods: All patients younger than 16 years admitted to the Tampere University Hospital's emergency department with a diagnosis of poisoning during 2002,2006 were identified from the Hospital Information System using the International Classification of Diseases (ICD-10). Results: Altogether 369 emergency visits were diagnosed with poisoning, the overall incidence being 8.1 per 10 000 person,years (95% CI 7.3,9.0). A majority of patients were adolescents aged 10,15 years (48%) and children under 5 years (45%). Boys represented 55% of the cases. Nonpharmaceutical agents were suspected to be the cause in 60.4% and pharmaceuticals in 30.6% of the intoxications. Multiple agents were involved in 8.4% of the cases. Ethanol was the agent in 30.9% of the poisonings. Most patients (78.9%) were hospitalized (median length of stay 1 day). Overall mortality was 0.3%. Conclusion: Acute paediatric poisonings represent a relatively frequent problem in Finland, and remain a life-threatening problem. The high proportion of alcohol poisonings highlights the necessity to develop more effective primary prevention programs. [source] Present and future therapeutic strategies for idiopathic oligozoospermiaINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 6 2000Dimitrios A. Adamopoulos The effectiveness of medical treatment for idiopathic oligozoospermia (IO) has been at best doubtful until now and a logical consequence of this unsatisfactory situation has been the partial displacement of this approach by assisted reproduction techniques. This state of affairs has resulted from insufficient investigation, inappropriately designed clinical trials and consistent disregard for the principles of evidence-based medicine. Protocol-related shortcomings and wrong interpretation of the data available have also been some of the all too frequent problems encountered in this therapeutic approach. In this rather misty situation, it appears that, of the therapeutic agents used so far, follicle stimulating hormone (FSH) (mainly FSH-secretagogues) may exert some beneficial effects on a number of biological endpoints related to spermatogenesis and sperm maturation. The short and medium term prospects of medical treatment for IO rest mainly with improvement of investigative procedures to a higher degree of sophistication, with emphasis placed on identifying the causes rather than the results of dysfunction so that a better selection of candidates can be made. Moreover, the introduction of prognostic indices for evaluation of the beneficial effects of a therapeutic agent may be of paramount importance. Finally, a better assessment of the preparations available and, possibly, the introduction of new more specific agents may also be an important step forward in this field. This type of large-scale effort should not be left to individual investigators or special centres working independently, but it may come under the auspices of a central regulating agency so that undisputed results from large, multicentre and uniform studies might be obtained, if medical treatment is to remain a good option. In this context, it may also be emphasized that andrology's main task should always be to treat the male with the problem rather than his healthy female partner, whenever this is possible. [source] Evaluation of 2407 fetuses in a Turkish populationPRENATAL DIAGNOSIS, Issue 9 2007Gülay Ceylaner Abstract Objectives Congenital anomalies and intrauterine fetal death (IUFD) are frequent problems in pregnancies. Detection of the etiology is important for genetic counseling, and presenting the geographic distribution of the causes of disorders is necessary for a national policy on precautions. Here, we report the findings of terminated fetuses due to IUFD and congenital anomalies in Turkish population. Methods Physical examinations of fetuses and genetic evaluations of families were done. X-ray studies and autopsy were done in the event of necessity. Findings of these studies were combined with prenatal ultrasound results. All cases were classified according to ICD-10. Results The number of fetuses examined was 2407. Out of these, 1268 fetuses had congenital anomalies. Neurologic anomalies and musculoskeletal system malformations were the most frequent disorders. Specific diagnoses were possible in 64% of all multiple malformation syndromes. Abnormal findings were detected in 18.8% of IUFD fetuses. Nine percent had congenital anomalies and 5.2% had cord complications. The percentage of twins and triplets was 7.5% and 13% of them had anomalies. Conclusion Postmortem evaluation is useful to detect findings necessary for genetic counseling. Our protocol is effective especially in fetuses with congenital anomalies but it can detect only some of the fetal reasons in IUFD cases. A more detailed protocol is needed to investigate IUFD cases. Copyright © 2007 John Wiley & Sons, Ltd. [source] Evaluation of Radiofrequency Thermal Ablation Results in Inferior Turbinate Hypertrophies by Magnetic Resonance ImagingTHE LARYNGOSCOPE, Issue 4 2007Tarik Sapci MD Abstract Objectives: Nasal obstruction caused by inferior turbinate hypertrophies is one of the most frequent problems in otolaryngology. Treatment of this disease may involve medical and surgical methods. Thermal ablation with radiofrequency energy has become quite popular in the recent years as one of the surgical methods used when medical therapy is not adequate. Study Design: Prospective, clinical trial. Methods: Thermal ablation with radiofrequency energy was used in this study on the inferior turbinates of 21 patients who had nasal obstruction caused by inferior turbinate hypertrophy only. The results were evaluated subjectively by preoperative and postoperative patient- and physician-assigned visual analogue scales and objectively by magnetic resonance imaging (MRI) investigation. Results: By the end of the postoperative week 10, 64.76% recovery was detected according to the patient evaluation, and 40.75% recovery was detected according to the physician evaluation. Measurement of the average volumes of the inferior turbinates by MRI revealed a 8.70% postoperative reduction. The most significant change was detected in the anterior-posterior length measurement performed in the axial plane. Conclusions: These results suggest that thermal ablation with radiofrequency energy is an easily applied, efficient, and reliable technique in treatment of the inferior turbinate hypertrophy, and that anterior-posterior length measurement in the axial section of the inferior turbinate by MRI, which is thought as an objective evaluation method, could be an efficient diagnostic tool in detecting the efficiency of radiofrequency on inferior turbinate. [source] Emotional and behavioural problems in subgroups of children with chronic illness: results from a large-scale population studyCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2009M. Hysing Abstract Background Children with chronic illness are known to have an increased risk of emotional and behavioural problems. In the present population-based study children with asthma, neurological disorders and other chronic illnesses were compared with children without chronic illnesses to assess differences in psychological presentation across illness groups. Methods A total of 537 children with parent-reported chronic illness in the Bergen Child Study were categorized into three groups: asthma, neurological disorders and other chronic illnesses. Emotional and behavioural problems were assessed by the Strengths and Difficulties Questionnaire. Results All three illness groups had an increased rate of emotional and behavioural problems, as well as increased probability of a psychiatric disorder compared with children without a chronic illness. Most children with asthma and other chronic illnesses did not have emotional and behavioural problems, and effect sizes were small in both groups. In children with neurological disorders the effect sizes ranged from moderate to large, with emotional problems, inattention hyperactivity and peer problems being the most frequent problems. Conclusions The increased rate of emotional and behavioural problems in children with chronic illness, especially neurological disorders, emphasizes the importance of early detection of mental health problems in these children. [source] Quality of life before and after proctocolectomy and IPAA in patients with ulcerative proctocolitis , a prospective studyCOLORECTAL DISEASE, Issue 2 2003I. Berndtsson Abstract Objective The principal aim of the present investigation was to study the general QoL and disease-specific adjustment before, and one-year after, operation with an ileal pouch anal-anastomosis (IPAA) in a consecutive series of patients with ulcerative colitis (UC). Patients and method Eleven patients were medically treated and 31 patients underwent colectomy with ileostomy. The patients were interviewed before the IPAA operation and again one-year after closure of the covering loop ileostomy. General quality of life was estimated with a Swedish instrument (according to Kajandi, score range 16,96) and a VA-scale. The instrument for disease-specific adjustment contained specific questions with five factors (score range 34,204). Open questions about quality of life were used to identify areas of concern, which were not included in the other instruments. Postoperative function was described in terms of a functional score (score range 0,15). Results The results of the general quality of life assessments did not differ significantly when comparing pre-operative to postoperative values. Disease-specific adjustment showed that the medically treated patients had a score of 162; interquartile range (IQR) 145,176. The patients with ileostomy scored 164; IQR 141,180. Postoperatively there was a statistically significant improvement in both groups to 189 (IQR 172,199), an increase of 15%. The open questions revealed restrictions in daily life for both patient groups pre-operatively with improvements after IPAA. The median grading of functional outcome according to the score system was 2. The most frequent problems were: patients who had occasional bowel movements at night, 40%; intermittent perianal soreness, 51%; antidiarrhoeal medication use, 61%. Conclusion General QoL did not change after IPAA. The bowel-specific adjustment in most factors improved in the majority of patients after IPAA. However, half of the IPAA patients had occasional bowel movements at night perianal soreness, and used antidiarrhoeal medication. [source] | ||||||||||