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Limited Time Period (limited + time_period)
Selected AbstractsInsulin is a kinetic but not a thermodynamic inhibitor of amylin aggregationFEBS JOURNAL, Issue 12 2009Wei Cui One of the most important pathological features of type 2 diabetes is the formation of islet amyloid, of which the major component is amylin peptide. However, the presence of a natural inhibitor such as insulin may keep amylin stable and physiologically functional in healthy individuals. Some previous studies demonstrated that insulin was a potent inhibitor of amylin fibril formation in vitro, but others obtained contradictory results. Hence, it is necessary to elucidate the effects of insulin on amylin aggregation. Here we report that insulin is a kinetic inhibitor of amylin aggregation, only keeping its inhibitory effect for a limited time period. Actually, insulin promotes amylin aggregation after long-term incubation. Furthermore, we found that this promotional effect could be attributed to the copolymerization of insulin and amylin. We also found that insulin copolymerized with amylin monomer or oligomer rather than preformed amylin fibrils. These results suggest that the interaction between insulin and amylin may contribute not only to the inhibition of amylin aggregation but also to the coaggregation of both peptides in type 2 diabetes. [source] Effect of an Independent-capacity Protocol on Overcrowding in an Urban Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 12 2009Won Chul Cha MD Abstract Objectives:, The authors hypothesized that a new strategy, termed the independent-capacity protocol (ICP), which was defined as primary stabilization at the emergency department (ED) and utilization of community resources via transfer to local hospitals, would reduce ED overcrowding without requiring additional hospital resources. Methods:, This is a before-and-after trial that included all patients who visited an urban, tertiary care ED in Korea from July 2006 to June 2008. To improve ED throughput, introduction of the ICP gave emergency physicians (EPs) more responsibility and authority over patient disposition, even when the patients belonged to another specific clinical department. The ICP utilizes the ED as a temporary, nonspecific place that cares for any patient for a limited time period. Within 48 hours, EPs, associated specialists, and transfer coordinators perform secondary assessment and determine patient disposition. If the hospital is full and cannot admit these patients after 48 hours, the EP and transfer coordinators move the patients to other appropriate community facilities. We collected clinical data such as sex, age, diagnosis, and treatment. The main outcomes included ED length of stay (LOS), the numbers of admissions to inpatient wards, and the mortality rate. Results:, A total of 87,309 patients were included. The median number of daily patients was 114 (interquartile range [IQR] = 104 to 124) in the control phase and 124 (IQR = 112 to 135) in the ICP phase. The mean ED LOS decreased from 15.1 hours (95% confidence interval [CI] = 14.8 to 15.3) to 13.4 hours (95% CI = 13.2 to 13.6; p < 0.001). The mean LOS in the emergency ward decreased from 4.5 days (95% CI = 4.4 to 4.6 days) to 3.1 days (95% CI = 3.0 to 3.2 days; p < 0.001). The percentage of transfers from the ED to other hospitals decreased from 3.5% to 2.5% (p < 0.001). However, transfers from the emergency ward to other hospitals increased from 2.9% to 8.2% (p < 0.001). Admissions to inpatient wards from the ED were significantly reduced, and admission from the emergency ward did not change. The ED mortality and hospital mortality rates did not change (p = 0.15 and p = 0.10, respectively). Conclusions:, After introduction of the ICP, ED LOS decreased without an increase in hospital capacity. [source] 4264: Regression of choroidal melanoma after primary chemotherapyACTA OPHTHALMOLOGICA, Issue 2010NE BECHRAKIS Purpose To describe the local regression of an intraocular choroidal melanoma after primary chemotherapy with fotemustine. Methods A 30 y.o. young man presented with drop of visual acuity in his lest eye to 0,8. The right eye was unremarkable with VA 1,2. On the same time he developed upper abdominal pain. On ophthalmic examination a circumpapillary choroidal melanoma was detected with possible optic nerve infiltration on his left eye. Ultrasound and MRI scan of the upper abdomen revealed a diffuse metastatic liver disease. Results In consultation with the department of oncology it was decided to prescribe systemic chemotherapy with fotemustine. After 4 cycles of chemotherapy, there was impressive local regression of the choroidal tumour and the liver metastases. Unfortunately after the initial response and the stable intraocular situation, there was tumour progression in other sites such as subcutaneous and lung metastases. After administration of some cycles of cisplatin as an alternative regime, the patient succumbed to the metastatic disease. Conclusion This case demonstrates that intravenous fotemustine can be effective for a limited time period as a primary treatment option in a case of choroidal melanoma, without other local treatment. [source] Double-blind randomized controlled trial study on post-extraction immediately restored implants using the switching platform concept: soft tissue response.CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2009Preliminary report Abstract Aim: To evaluate the soft tissue response to immediately placed implants using the platform switching concept. Material and methods: In 22 patients, 22 implants of 5.5 mm platform diameter were placed immediately into fresh extraction sockets in maxillae without compromised bone tissue. Eventual post-extraction bone defects were filled using bovine bone matrix mixed with collagen. Immediately after insertion, implants were randomly divided: 11 implants were connected with a 3.8 mm diameter abutment (test group) and 11 with a 5.5 mm diameter abutment (control group). A provisional crown was adapted and adjusted for non-functional immediate positioning. Two months later, definitive prosthetic rehabilitation was performed. Periodontal parameter, buccal peri-implant mucosal changes (REC), mesial and distal papilla height (PH) and vertical height of jumping distance (VHG) were measured at the time of implant placement, of definitive prosthesis insertion and every 6 months thereafter. Results: The mean follow-up was 25 months. All implants were clinically osseointegrated. The test group showed a +0.18 mm REC gain. PH gain was +0.045 mm on average. The mean values were statistically significant (P,0.005) compared with the control group (PH=,0.88 mm; REC=,0.45 mm). No difference between the two groups in periodontal parameters was found. The mean value of bone filling was 7.51 mm in the test group (97.4% of VHG) and 8.57 mm in the control group (95.2% of VHG). No statistically significant difference was found between the two groups. Conclusions: This study suggests that, in a limited time period of 2 years, immediately placed implants with subsequent platform switching can provide peri-implant tissue stability. [source] Music and its effect on anxiety in short waiting periods: a critical appraisalJOURNAL OF CLINICAL NURSING, Issue 2 2005Marie Cooke PhD Aims and objectives., This paper undertakes a critical appraisal of the methodological issues associated with studies that have investigated the extent to which music decreased the anxiety experienced by patients in short-term waiting periods such as day surgery. Background., Investigations and surgery undertaken on a day basis have significantly increased in number over the last decade. Music has been evaluated as an appropriate nursing intervention in relation to pain, discomfort and anxiety in a number of clinical settings but its usefulness for decreasing anxiety in short-term waiting periods such as day surgery is only beginning to be understood. Conclusion., A number of methodological limitations are identified by this critical review, particularly in relation to the design of research studies. Recommendations to strengthen research in this area are suggested and include (i) describing methods clearly and with detail to allow assessment of the validity and rigour of study results; (ii) using permuted block randomization; (iii) recruiting from a variety of surgical procedures and cultural groups; and (iv) standardizing the health care provided during waiting period. Relevance to clinical practice., Music as a simple and cost-effective intervention to reduce the anxiety experienced in limited time periods will have enormous impact on clinical practice where patients wait and undergo invasive investigations, procedures or surgery. However, the evidence of its utility in these unique environments is only beginning to emerge and this critical review provides a basis for considerations for future research. [source] Physical activity of poor urban women in Cali, Colombia: A comparison of working and not working womenAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 4 2003D.L. Dufour We have previously presented evidence that the physical activity level (PAL) and total energy expenditure (per kg body weight) of poor urban women who "work" (engage in income-earning activities) is similar to those who do not "work" (but do tend to household and childcare responsibilities) (Spurr et al. [1996] Am J Clin Nutr 63:870,878; [1997] Med Sci Sports Exerc 29:1255,1262). These findings were unexpected and raised questions regarding the actual types of activities engaged in by the two groups. In this article we address those questions by comparing the time allocation of the two groups. Time allocation during waking hours (14.2 ± 1.1 hours/day) was recorded in minute-by-minute diaries by trained observers for two consecutive days for 52 working women and 28 not-working women. The working women were engaged in predominately informal sector economic activities, such as street vending, childcare, and domestic service, in addition to their own household and childcare responsibilities. The activities of the not-working women were largely restricted to household and childcare responsibilities. The working women tended to spend less time in resting activities and TV-watching and more time in travel and miscellaneous work activities, but other between-group differences were not significant. We conclude that the time allocation of working women is similar to that of not-working women because 1) many of the activities engaged in are the same or similar, and 2) some working women are only engaged in income-earning activities for limited time periods. Am. J. Hum. Biol. 15:490,497, 2003. © 2003 Wiley-Liss, Inc. [source] | ||||||||||