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Longer Duration (longer + duration)
Selected AbstractsSevere hypoglycaemia during pregnancy in women with Type 1 diabetes is common and planning pregnancy does not decrease the riskDIABETIC MEDICINE, Issue 8 2009H. Robertson Abstract Aims, The aim of this study was to identify risk factors for severe hypoglycaemia (SH) in pregnancy in Type 1 diabetes, including associations with pregnancy planning and glycaemic control. Methods, Clinical data including details of the pregnancy and its outcome, glycaemic control, frequency of SH and evidence of pregnancy planning were collected prospectively as part of a national audit of 160 pregnancies in women with Type 1 diabetes. Results, An episode of SH was experienced by 29.4% of women at some point during the pregnancy, with the percentage of women experiencing SH decreasing from 21.9% in the first trimester to 18.1% in trimester 2 and 10.9% in trimester 3. Longer duration of diabetes was associated with increased frequency of SH during pregnancy (r = 0.191, P = 0.012). A greater fall in glycated haemoglobin (HbA1c) between pre-pregnancy and the first trimester was not associated with increased risk of SH in trimester 1. Planned pregnancies had better glycaemic control but higher risk of SH in trimester 1 (P = 0.047). Women with pre-pregnancy retinopathy and current smokers had an increased risk of SH in trimester 3 (P = 0.029, P = 0.033). Conclusions, SH is common during pregnancy and particularly in the first trimester. Planning pregnancy does not decrease the risk of SH. Improvements in glycaemic control at the start of pregnancy do not appear to increase the risk of SH. Education of women and their partners about the risks of SH and its management is essential when planning pregnancy. [source] Male Performance and Body Size Affect Female Re-Mating Occurrence in the Orb-Web Spider Leucauge mariana (Araneae, Tetragnathidae)ETHOLOGY, Issue 12 2009Anita Aisenberg Females can affect male probabilities of paternity success through behavioural, morphological and/or physiological processes occurring during or after copulation. These processes under female-control include the acceptance or rejection of mating attempts by subsequent males. Leucauge mariana is an orb weaving spider that shows male mate guarding of penultimate females, male,male competition on female webs and copulatory plugs, suggesting a polyandric mating system. The aim of the present study was to ascertain whether male behaviour during courtship and copulation in L. mariana relate with female re-mating decisions. Forty-three virgin females were exposed to up to three males until they mated. In 24 cases, the copulatory plug was absent after mating and females were exposed the next day to up to three other males. Eighteen females accepted a second mating. Relatively larger females were more receptive to second matings and were more likely to copulate if the second male was smaller. Longer duration of female tapping and abdominal bobbing during courtship, and first copulations with less short insertions and more flubs, were associated with increased female acceptance to second matings. The results indicate cryptic female choice on male courtship and copulatory performance and suggest female-control over the determination of male mating success in this spider species. [source] Erratum: Longer duration of viremia and unique amino acid substitutions in a hepatitis A virus stain associated with Guillain,Barré syndrome (GBS)JOURNAL OF MEDICAL VIROLOGY, Issue 11 2010Madhuri S. Joshi No abstract is available for this article. [source] Study of Japanese encephalitis and other viral encephalitis in Nepali childrenPEDIATRICS INTERNATIONAL, Issue 6 2007AJIT RAYAMAJHI Abstract Background: A hospital-based prospective cross-sectional study was conducted in children aged 1 month,14 years to identify the proportion of viral encephalitis due to Japanese encephalitis (JE) and compare the clinico-laboratory profile and outcome of JE with that of other viral encephalitis (non-JE). Methods: All probable cases of viral encephalitis on clinical and laboratory evaluation were confirmed as JE on anti-JE IgM in cerebrospinal fluid (CSF) and/or serum. Patients not having anti-JE IgM in CSF and/or serum were diagnosed as having non-JE. Results: Of 94 cases, 58 were JE and 36 non-JE. Although practice of rearing pigs at home was associated with JE (P = 0.0001), significantly higher serum creatinine, protein, aspartate aminotransferase and CSF protein levels were observed in non-JE. Longer duration of fever was associated with complete recovery in JE whereas shorter duration of fever was associated with recovery in non-JE. Risk of neurological sequelae (P = 0.01), especially hemiparesis (P = 0.03) was significantly more in JE. Sequelae were observed at 6 weeks follow up in 18.8% of JE and 13.9% of non-JE. Conclusion: JE was the most common cause of viral encephalitis in eastern Nepal and should be suspected in encephalitic patients having pig rearing at home and neurological sequelae. Although duration of hospitalization and complication were higher in JE, final outcome was similar to non-JE. Longer duration of fever in JE and shorter duration of fever in non-JE correlated with recovery, while altered sensorium and focal neurological deficit were independent predictors of sequelae at 6 weeks only in JE and not in non-JE. [source] Early-life nutritional and environmental determinants of thymic size in infants born in rural BangladeshACTA PAEDIATRICA, Issue 7 2009SE Moore Abstract Aim:, The aim was to assess the impact of nutritional status and environmental exposures on infant thymic development in the rural Matlab region of Bangladesh. Methods:, In a cohort of Nmax 2094 infants born during a randomized study of combined interventions to improve maternal and infant health, thymic volume (thymic index, TI) was assessed by ultrasonography at birth and at 8, 24 and 52 weeks of age. Data on birth weight, infant anthropometry and feeding status were also collected. Results:, At all ages, TI was positively associated with infant weight and strongly associated with the month of measurement. Longer duration of exclusive breastfeeding resulted in a larger TI at 52 weeks. TI at birth and at 8 weeks correlated positively with birth weight, but by 24 and 52 weeks and when adjusted for infant weight this effect was no longer present. Thymic size was not affected by pre-natal maternal supplementation or by socioeconomic status but was correlated to arsenic exposure during pregnancy. Conclusion:, In this population of rural Bangladeshi infants, thymic development is influenced by both nutritional and environmental exposures early in life. The long-term functional implications of these findings warrant further investigation. [source] Heart Rate-Defined Phases of Attention, Look Duration, and Infant Performance in the Paired-Comparison ParadigmCHILD DEVELOPMENT, Issue 6 2001John Colombo Four-month-old infants (N= 68) were tested in a paired-comparison familiarization , novelty recognition task in which the length of choice trials was systematically manipulated. Peak look duration during pretest and familiarization periods significantly predicted a dichotomous measure of recognition performance, but recognition was unaffected by choice-trial length. Heart rate (HR) was simultaneously assessed during the task, and the amount of time infants spent in various HR-defined phases of attention was assessed. Longer durations of looking during pretest and familiarization were significantly associated with more time spent in both sustained attention (SA) and attention termination (AT). Of these two variables, only individual differences in AT accounted for significant variance in recognition memory performance. A final analysis addressed the possibility that individual differences in AT mediated the relation between look duration and recognition performance. These findings provide support for the hypothesis that individual differences in the disengagement of attention underlie the relation between look duration and cognitive performance in early to midinfancy. [source] Gait disturbance interpreted as cerebellar ataxia after MMR vaccination at 15 months of age: a follow-up studyACTA PAEDIATRICA, Issue 1 2000A-M Plesner Measles, mumps and rubella (MMR) vaccination was included in the Danish childhood vaccination programme in 1987. During the following 10-y period, 550 notification records of adverse events after MMR vaccination at 15 mo of age have been registered, and a total of 41 notifications have included "gait disturbance". This corresponds to a frequency of 8 per 100 000 doses of MMR vaccine used for 15-mo-old children. The symptoms and signs are characteristic of cerebellar ataxia. In 28 notifications, the descriptions by the doctors included only "gait disturbance", while in 13 an additional interpretation was included. Thirty-two parents (78%) filled in a questionnaire and 26 (63%) agreed to participate in a clinical follow-up study. The gait disturbance symptoms mainly occurred 7,14 d after the vaccination, and the duration was median 1,2 wk (range 1 d to more than 4 mo). One-third of the children had symptoms lasting more than 2 wk. Significantly more children with long duration of symptoms had some kind of complaint or clinical signs at the follow-up in 1997. Gait disturbance registered after MMR vaccination seems to be more frequent than hitherto reported. Most cases are mild and short-lasting and a longer duration of symptoms seems to be predictive of late sequelae. A clinical diagnosis of cerebellar ataxia after MMR and the exact frequency of this adverse event remains to be tested in prospective studies. [source] Are multi family groups appropriate for patients with first episode psychosis?ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010A 5-year naturalistic follow-up study Rossberg JI, Johannessen JO, Klungsoyr O, Opjordsmoen S, Evensen J, Fjell A, Haahr U, Joa I, Langeveld J, Larsen TK, Melle I, Rund BR, Simonsen E, ten Velden W, Vaglum P, Friis S, McGlashan T. Are multi family groups appropriate for patients with first episode psychosis? A 5-year naturalistic follow-up study. Objective:, To compare outcome over 5 years for patients who participated in multi family groups (MFGs) to those who refused or were not offered participation. Method:, Of 301 first episode psychotic patients aged 15,65 years, 147 participated in MFGs. Outcome was measured by drop-out rates, positive and negative syndrome scale (PANSS) symptom scores, and duration of psychotic episodes during the follow-up period. Results:, Multi family group participants had a significantly lower drop-out rates at 5-year follow-up than patients who did not participate. However, the MFG participants had significantly less improvement in PANSS positive and excitative symptoms and had significantly longer duration of psychotic symptoms during the follow-up period. Conclusion:, Multi family groups appear to increase the chance of retaining patients in a follow-up study, but adjustment of the programme may be necessary with first episode psychosis patients to meet their needs better. [source] Early adversity in chronic depression: clinical correlates and response to pharmacotherapy,,DEPRESSION AND ANXIETY, Issue 8 2009Daniel N. Klein Ph.D. Abstract Background: There is growing evidence suggesting that early adversity may be a marker for a distinct pathway to major depressive disorder (MDD). We examined associations between childhood adversity and a broad variety of clinical characteristics and response to pharmacotherapy in a large sample of patients with chronic forms of MDD. Methods: Subjects included 808 patients with chronic forms of MDD (chronic MDD, double depression, or recurrent MDD with incomplete recovery between episodes and a total continuous duration of >2 years) who were enrolled in a 12-week open-label trial of algorithm-guided pharmacotherapy. Baseline assessments included a semi-structured diagnostic interview, and clinician- and self-rated measures of depressive symptoms, social functioning, depressotypic cognitions, and personality traits, and childhood adversity. Patients were re-evaluated every 2 weeks. Results: A longer duration of illness; earlier onset; greater number of episodes, symptom severity, self-rated functional impairment, suicidality, and comorbid anxiety disorder; and higher levels of dysfunctional attitudes and self-criticism were each associated with multiple forms of childhood adversity. A history of maternal overcontrol, paternal abuse, paternal indifference, sexual abuse, and an index of clinically significant abuse each predicted a lower probability of remission. Among patients completing the 12-week trial, 32% with a history of clinically significant abuse, compared to 44% without such a history, achieved remission. Conclusions: These findings indicate that a history of childhood adversity is associated with an especially chronic form of MDD that is less responsive to antidepressant pharmacotherapy. Depression and Anxiety, 2009. Published 2009 Wiley-Liss, Inc. [source] Do memory complaints represent impaired memory performance in patients with major depressive disorder?DEPRESSION AND ANXIETY, Issue 10 2008Arash Mowla M.D. Abstract Memory complaints are found to be associated with depression. However, the question is, "How much these subjective complaints indicate objective memory impairments?" The aim of this study is to determine whether subjective memory complaints represent objective memory impairments and to establish the demographic and clinical characteristics of patients with major depressive disorder (MDD) and subjective memory complaints. Sixty-four patients with MDD were assessed for objective memory performance through subtests of the Wechsler Memory Scale-III. Memory complaints also were assessed in these patients with a structured interview. Thirty healthy controls were also included in the study to compare memory performance among groups. The Hamilton Rating Scale for Depression was used to measure the severity and characteristics of depression. Patients with MDD who had longer duration and earlier onset of depression reported more memory complaints. MDD patients with memory complaints had more hypochondriac concerns but not more depression severity compared with those without memory complaints. There was no relationship between subjective memory complaints and objective memory performance in MDD patients. Patients with MDD with and without memory complaints had lower scores on the Wechsler Memory Scale-III than the control group. Subjective memory complaints are not a valid indictor of objective memory impairments, and the diagnostic value of self-reported memory is being questioned in patients with MDD. The cognitive status of MDD patients should be assessed routinely, regardless of the patient awareness of his or her cognitive deficits. Depression and Anxiety, 2008. © 2007 Wiley-Liss, Inc. [source] Achieving symptomatic remission in out-patients with schizophrenia , a naturalistic study with quetiapineACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009T. Wobrock Objective:, Symptomatic remission was defined as a score of mild or less on each of eight key schizophrenia symptoms on the Positive and Negative Syndrome Scale (PANSS-8). To evaluate the symptomatic remission criterion in clinical practice and to determine predictors for achieving symptomatic remission, a 12-week non-interventional study (NIS) with quetiapine was conducted in Germany. Method:, For the comparison of patients with and without symptomatic remission, sociodemographic and clinical variables of 693 patients were analyzed by logistic regression for their predictive value to achieve remission. Results:, Four hundred and four patients (58.3%) achieved symptomatic remission after 12 weeks' treatment with quetiapine. Remission was significantly predicted by a low degree of PANSS-8 total score, PANSS single items blunted affect (N1), social withdrawal (N4), lack of spontaneity (N6), mannerism and posturing (G5), and low disease severity (CGI-S) at baseline. Predictors of non-remission were older age, diagnosis of schizophrenic residuum, multiple previous episodes, longer duration of current episode, presence of concomitant diseases, and alcohol abuse. Conclusion:, This study demonstrated that the majority of schizophrenia out-patients achieved symptomatic remission after 12 weeks treatment and confirms the importance of managing negative symptoms in order to achieve disease remission. [source] Outcome of late-life depression after 3 years of sequential treatmentACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2009R. M. Kok Objective:, To study the outcome of a sequential treatment protocol in elderly, severely depressed in-patients. Method:, All 81 patients from a 12-week double-blind randomized controlled trial (RCT) comparing venlafaxine with nortriptyline were asked to participate in a 3 year follow-up study. Thirty-two patients who did not achieve remission during the RCT, entered an open sequential treatment protocol and were treated with augmentation with lithium, switch to a monoamine oxidase inhibitor or ECT. Results:, Seventy-eight of the 81 patients (96.3%) achieved a response [,50% reduction in Montgomery Åsberg Depression Rating Scale score) and 68 patients (84%) a complete remission (final MADRS score , 10) within 3 years of treatment. Greater severity and longer duration of the depressive episode at baseline predicted poor recovery. Augmentation with lithium may be the best treatment option in treatment resistant depressed elderly. Only few patients dropped-out due to side-effects. Conclusion:, Our study demonstrates the importance of persisting with antidepressant treatment in elderly patients who do not respond to the first or second treatment. [source] Parental psychopathology and self-rated quality of life in adolescents with epilepsy in NigeriaDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2006Abiodun O Adewuya MBChB This study sought to investigate the relationship between parental psychopathology and health-related quality of life in a group of Nigerian adolescents with epilepsy. The participants were 86 adolescents with epilepsy (50 males, 36 females; mean age 14y 5mo [SD 2y 1mo]; age range 12,18y). There were 54 (62.8%) adolescents with complex partial seizures, six (7.0%) with simple partial seizures, 14 (16.3%) with generalized tonic-clonic seizures, four (4.7%) with absence seizures, and eight (9.2%) with other types of seizure. They completed the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48). Parents also completed the General Health Questionnaire, Zung's Self-Rating Anxiety Scale, and Zung's Self-Rating Depressive Scale as measures of their psychopathology. Factors correlating with poor overall quality of life in the adolescents include longer duration of illness, large number of antiepileptic drugs, more severe medication toxicity, and psychopathology in the parents. General psychopathology in parents is significantly associated with QOLIE-AD-48 subscales of Epilepsy Impact (r= 0.527, p < 0.001), Attitude (r= 0.214, p= 0.047), Physical Function (r= 0.417, p < 0.001), Stigma (r= 0.305, p= 0.004), Social Support (r= 0.365, p= 0.001), and School Behaviour (r= 0.220, p= 0.042). There is a possibility of a cross-cultural difference on the effect of epilepsy on the quality of life of adolescents. Psychopathology in parents is significantly associated with poorer quality of life of these adolescents. Physicians should consider this, therefore, when planning intervention strategies in improving the quality of life in adolescents with epilepsy. [source] Insulin analogues: an example of applied medical scienceDIABETES OBESITY & METABOLISM, Issue 1 2009B. Sheldon Insulin analogues were developed to try and achieve more physiological insulin replacement from injection in the subcutaneous site. Their pharmacokinetics and pharmacodynamics differ from human insulin when injected subcutaneously because of alterations in the amino acid sequence of the insulin molecule. The rapid-acting insulin analogues, lispro, aspart and glulisine, have a rapid onset of action and shorter duration of action because of changes to the B26,30 portion of insulin inhibiting formation of dimers and hexamers. They appear to improve postprandial glucose, incidence of hypoglycaemia and patient satisfaction and, when used in combination with basal insulin analogues, improve glycosylated haemoglobin in comparison to conventional insulin therapy. Additionally, they have been successfully used in children, pregnant women, in pump therapy and as part of premixed biphasic regimens. The two basal insulin analogues, glargine and detemir, developed by adjusting the isoelectric point and adding a fatty acid residue, respectively, have a protracted duration of action and a relatively smooth profile. Their pharmacokinetic and pharmacodynamic profiles have been assessed using euglycaemic clamp protocols. Both analogues have a longer duration of action, less of a peak of activity and a reduced variability with repeated injection. There is some evidence to suggest that detemir may have a slight hepatoselective effect. Clinical studies have shown a lower relative risk of hypoglycaemia and detemir appears to have a weight-sparing action. Insulin analogues represent a successful example of applied medical science. [source] Differential effects of short and long duration insulinotropic agents on meal-related glucose excursionsDIABETES OBESITY & METABOLISM, Issue 2 2001C. J. De Souza SUMMARY Aim Abnormal ,-cell function, characterized as the inability of the ,-cell to mount a rapid secretory response to glucose, is a well-established pathology of type 2 diabetes mellitus. These studies were designed to demonstrate the importance of early insulin release on the control of meal-induced glucose excursions by capitalizing on the significant pharmacodynamic differences between several oral insulin secreting agents. Methods Male Sprague Dawley fitted with indwelling jugular cannulas were used to compare the pharmacodynamic profiles of nateglinide (Nateg), glipizide (Glip) and repaglinide (Repag) through frequent blood samples following the administration of these compounds via oral gavage. In similar animals which were pretrained to consume their daily food intake in two discrete 45-min meals, the effects of compound induced changes in pre-meal, meal and post-meal insulin profiles on glycaemic control were assessed through frequent blood sampling following the administration of these compounds 10 min prior to a 30-min meal. Results There were significant pharmacodynamics differences between the three oral agents tested and the time to elicit peak insulin secretory responses increased from Nateg (4 min) to Repag (10 min) to Glip (45 min). During the meal tolerance test, glibenclamide did not increase pre-meal insulin levels and glucose excursions paralleled those in the control. Conversely, the other three agents, at doses that produced hypoglycaemic responses of similar magnitude, all increased early insulin release (,AUC(-15 to 3 min) = 0.5 ± 0.01, 1.6 ± 0.4, 3.6 ± 0.0, 1.2 ± 0.1 and 1.73 ± 0.4 nmol/min, for control, Nateg at 60 and 120 mg/kg, Glip and Repag, respectively) and curbed glucose excursions during the meal at varying rates and degrees (,AUC(0,30 min) = 39 ± 6, 8 ± 7, 5 ± 7, ,,1 ± 8 and ,,3 ± 8 mmol/min for control, Nateg at 60 and 120 mg/kg, Glip and Repag, respectively). However, unlike Nateg, the longer duration of action of Repag and Glip elicited sustained post-meal relative hypoglycaemia. Conclusion These data support the impact of early and rapid insulin release in the control of prandial and post-meal glycaemia and demonstrate that a short anticipatory burst of insulin, restricted to the beginning of a meal, provides a clear metabolic advantage and prevents post-meal hypoglycaemic episodes when compared to a greater but reactive insulin exposure that follows a meal-induced increase in glucose excursion. [source] Subclinical vascular alterations in young adults with type 1 diabetes detected by arterial tonometryDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 8 2009I. Barchetta Abstract Background Diabetes mellitus is characterized by a very high prevalence of atherosclerotic disease. Aims of this study were to determine arterial compliance parameters in type 1 diabetes (T1D) patients as an expression of early pre-clinical endothelial dysfunction and to evaluate the impact of glucose exposure parameters such as the duration of diabetes and glycosylated haemoglobin (HbA1c) on the risk of developing alterations in vascular compliance. Methods 23 patients with uncomplicated type 1 diabetes (mean age: 32.78 ± 9.06 years, mean disease duration: 10.78 ± 7.51 years, mean HbA1c levels: 7.7 ± 1.9) and 26 age- and sex-matched healthy subjects (mean age: 32.3 ± 8.51 years) were recruited. In these subjects, we evaluated arterial compliance by calibrated tonometry (HDI/PulsewaveÔ CR-2000). Parameters included the following: large artery elasticity (C1), small artery elasticity (C2), systemic vascular resistance (SVR) and total vascular impedance (TVI). Results Patients with longer duration of T1D (>10 years) showed significant alterations in C2 (4.97 ± 2.7 mL/mmHg × 100) and in SVR (1464.67 ± 169.16 dina × s × cm,5) when compared with both healthy individuals (C2: 8.28 ± 2.67 mL/mmHg × 100, p = 0.001; SVR: 1180.58 ± 151.55 dina × s × cm,5, p = 0.01) and patients with recent-onset disease (,10 years) (C2: 10.02 ± 3.6 mL/mmHg × 100, p < 0.001; SVR: 1124.18 ± 178.5 dina × s × cm,5, p < 0.000). Both disease duration and HbA1c independently predicted impaired arterial compliance. Conclusions Young adult T1D patients with no signs of disease complication have detectable vessel wall abnormalities, particularly of small arteries, suggestive of hyperglycaemia-related early endothelial dysfunction. Copyright © 2009 John Wiley & Sons, Ltd. [source] A 75% insulin lispro/25% NPL mixture provides a longer duration of insulin activity compared with insulin lispro alone in patients with Type 1 diabetesDIABETIC MEDICINE, Issue 11 2003P. Roach Abstract Aims To compare a new insulin formulation, high mix (HM) [75% lispro (LP) and 25% neutral protamine lispro (NPL)], to regular human insulin (HR) and LP with respect to glucose response and pharmacokinetics following a test meal in patients with Type 1 diabetes. Methods After fasting overnight, patients received an intravenous insulin infusion to standardize blood glucose (BG) to 7.5 mmol/l (135 mg/dl). In a randomised, three-way crossover study, HR was injected 30 min before, and LP or HM was injected immediately before the test meal on three separate occasions. For each patient, LP and HR were administered at identical doses; the HM dose was one and one third times that of HR and LP to maintain the same dose of short or rapid-acting insulin. The insulin infusion was stopped 15 min after the insulin injection. Free insulin and BG concentrations were measured frequently for 7 h following the test meal. Results HM and LP resulted in better glycaemic control than HR during the observation period. BG concentrations during the first 4,5 h did not differ between HM and LP. However, HM exhibited prolonged insulin activity relative to LP beyond 5 h, extending the duration of action by approximately 1 h, and resulting in lower overall BG concentrations when the 0,6- and 0,7-h intervals were considered. Conclusions Compared with LP, HM provided similar glycaemic control for up to 5 h and superior glycaemic control from 5 to 7 h following a standard test meal [source] Factors predictive of nephropathy in DCCT Type 1 diabetic patients with good or poor metabolic controlDIABETIC MEDICINE, Issue 7 2003L. Zhang Abstract Aims The study aim was to assess the time-related risk of developing diabetic nephropathy [albumin excretion rate (AER) , 40 mg/24 h] from baseline covariates in Type 1 diabetic patients with either good or poor metabolic control (MC). Methods Based on material from the Diabetes Control and Complications Trial study (n = 1441), patients were considered as under good or poor MC if their HbA1c mean level up to last visit fell in the lowest (, 6.9%) or highest (, 9.5%) quintile of the overall HbA1c distribution, respectively. Prevalence cases of nephropathy were excluded from the study. Survival analysis and Cox regression were applied to the data. Results Among patients with good MC (n = 277), 15% had developed nephropathy at the end of the study. Conversely, among patients with poor MC (n = 268), the proportion without the complication was 52%. When adjusting for MC, time to diabetic nephropathy was related to age (P < 0.0001), AER (P < 0.001), duration of diabetes (P < 0.005), body mass index (BMI) (P < 0.005), all at baseline, and to gender (P < 0.01). Patients with upper normal range AER levels, longer duration of diabetes and lower BMI were at higher risk, regardless of MC. The adverse effect of younger age on diabetic nephropathy was more marked in good than in poor MC. Although women tended to develop the complication more often under good MC, they appeared to be better protected under poor MC. Conclusions This study confirms occurrence of diabetic nephropathy under good MC and non-occurrence of the complication despite poor MC. It also demonstrates that some baseline covariates can affect, in a differential manner, time to diabetic nephropathy depending on MC. Diabet. Med. 20, 580,585 (2003) [source] Prescribing drug of choice to opiate dependent drug users: a comparison of clients receiving heroin with those receiving injectable methadone at a West London drug clinicDRUG AND ALCOHOL REVIEW, Issue 3 2001NICKY METREBIAN Abstract Fifty-eight long-term treatment resistant opiate-dependent drug users were offered the choice of receiving injectable heroin or injectable methadone at a West London drug clinic. Drugs were dispensed on-site at the clinic with weekend take-home. There was no routine ongoing supervised injecting. A ceiling dose of 200mg/day of heroin or methadone was set. One-third chose injectable methadone. Compared to those choosing heroin, these drug users were less likely to have used heroin or crack/cocaine before entering treatment, and were more likely to have previously received treatment with injectable methadone. Drug users reported choosing methadone because it was their primary drug of addiction, and compared with heroin has a longer duration of action and increased strength. Problems with each drug were reported: those choosing heroin complained that the upper dose limit was too low to maintain them adequately, and some receiving methadone complained of discomfort while injecting intravenously. While those choosing each drug had different baseline characteristics, both groups were well retained in treatment and at 3 months made significant reductions in drug use and crime, which were sustained over the 12-month follow-up period. There was no significant difference between treatment outcome between each group. There is an urgent need to conduct randomized controlled trials to establish the effectiveness of prescribing injectable methadone and heroin to inform policy and practice. [source] Stigma and treatment delay in first-episode psychosis: a grounded theory studyEARLY INTERVENTION IN PSYCHIATRY, Issue 1 2010Lauren Franz Abstract Aim: A longer duration of untreated psychosis (DUP) is associated with greater morbidity in the early course of schizophrenia. This formative, hypothesis-generating study explored the effects of stigma, as perceived by family members, on DUP. Methods: Qualitative interviews were conducted with 12 African American family members directly involved in treatment initiation for a relative with first-episode psychosis. Data analysis relied on a grounded theory approach. A testable model informed by constructs of Link's modified labelling theory was developed. Results: Four main themes were identified, including: (i) society's beliefs about mental illnesses; (ii) families' beliefs about mental illnesses; (iii) fear of the label of a mental illness; and (iv) a raised threshold for the initiation of treatment. A grounded theory model was developed as a schematic representation of the themes and subthemes uncovered in the family members' narratives. Conclusions: The findings suggest that due to fear of the official label of a mental illness, certain coping mechanisms may be adopted by families, which may result in a raised threshold for treatment initiation, and ultimately treatment delay. If the relationships within the grounded theory model are confirmed by further qualitative and quantitative research, public educational programs could be developed with the aim of reducing this threshold, ultimately decreasing DUP. [source] The rationale for early intervention in schizophrenia and related disordersEARLY INTERVENTION IN PSYCHIATRY, Issue 2009Merete Nordentoft Abstract Aim: To examine the rationale and evidence supporting an early intervention approach in schizophrenia. Methods: A selective literature review was conducted. Results: During the onset of schizophrenia, there is often a significant delay between the emergence of psychotic symptoms and the initiation of treatment. The average duration of untreated psychosis is around 1,2 years. During this period, brain function may continue to deteriorate and social networks can be irreversibly damaged. Studies have consistently linked longer duration of untreated psychosis with poorer outcomes and this relationship holds even after controlling for the potential confounding variable of premorbid functioning. In Norway, the early Treatment and Intervention in PSychosis study demonstrated that duration of untreated psychosis is amenable to intervention with the combination of educational campaigns and specialized early detection units substantially decreasing the period from onset of symptoms to treatment initiation. Furthermore, recent evidence from the randomized controlled OPUS and the Lambeth Early Onset trial studies have linked phase-specific early interventions to improved outcomes spanning symptoms, adherence to treatment, comorbid drug abuse, relapse and readmission. Some benefits persist after cessation of the intervention. Conclusions: Early intervention in schizophrenia is justified to reduce the negative personal and social impact of prolonged periods of untreated symptoms. Furthermore, phase-specific interventions are associated with improved outcomes, at least in the short term. Further research is needed to establish the optimum duration of such programmes. [source] Duration of strong ground motion during Mexican earthquakes in terms of magnitude, distance to the rupture area and dominant site periodEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 5 2001Eduardo Reinoso Abstract A study of the duration of strong ground motion using accelerometric data of subduction and normal-faulting Mexican earthquakes is presented. Duration is obtained based on the time between 2.5 and 97.5 per cent of the Arias intensity. An expression to predict this duration in terms of the magnitude, distance to the rupture area and site period is proposed and compared with predictions available in the literature. The effect of large duration for very distant sites and the contribution of soft soils to the duration of strong ground motion are widely discussed. We have found that large magnitude not only yields long duration at the source, but also proportionally longer duration with distance and with dominant site period compared to small magnitude. The duration obtained from the regression is used as a parameter to obtain input and hysteretic energy and on the use of damage models available in the literature. Finally, duration is used together with the random vibration theory to predict response spectra. Copyright © 2001 John Wiley & Sons, Ltd. [source] POSTED OFFER MARKETS IN NEAR-CONTINUOUS TIME: AN EXPERIMENTAL INVESTIGATIONECONOMIC INQUIRY, Issue 3 2009DOUGLAS D. DAVIS This paper reports an experiment conducted to evaluate a "near-continuous" variant of the posted offer trading institution, where the number of periods in a market session is increased by reducing sharply each period's maximum length. Experimental results suggest that although decisions in time-truncated periods are not equivalent to periods of longer duration, extensive repetition improves considerably the drawing power of equilibrium predictions in some challenging environments. Nevertheless, significant deviations remain in the near-continuous framework. We also observe that the extra data collected in the near-continuous framework allow new insights into price convergence and signaling. (JEL C92, L12, L11) [source] Improved resolution with microchip-based enhanced field inversion electrophoresisELECTROPHORESIS, Issue 11 2003Christopher J. Backhouse Abstract We present an improvement of the field inversion electrophoresis (FIE) method in which the passage of sample such as DNA back and forth within a short length of a microchannel can provide a similar resolution to that of a significantly longer microchannel. In constant field FIE the application of an alternating potential (e.g., +/, V) over short periods of time (e.g., several Hz) can provide enhanced separations of DNA fragments. In contrast, the present method consists of a series of separations, each of much longer duration, under high and low fields in such a way that the resolution is enhanced. This method is readily modeled and allows improved resolution to be obtained from extremely short microchannels (e.g., 8 mm) while requiring relatively low applied voltages (e.g., less than 600 V). An additional advantage is that this method can allow for the same equipment to be used in a rapid, low-resolution mode or in a slower, high-resolution mode through what might be referred to as an automated "zoom" capability. We believe that this method may facilitate the integration of microfluidic devices and microelectronic devices by allowing these devices to be of a similar small scale (< 1 cm). [source] Cholinesterase activity and behavior in chlorpyrifos-exposed Rana sphenocephala tadpolesENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 9 2006Pamela D. Widder Abstract Recent studies have found a correlation between organophosphate (OP) pesticide exposure and declines in amphibian populations. We evaluated the hypothesis that this relationship is driven by behavioral changes in developing larvae. Specifically, we examined how exposure to a common OP pesticide, chlorpyrifos, influenced cholinesterase (ChE) activity, mass, and swim speed in Rana sphenocephala tadpoles. We also determined how the presence of natural pond sediments in exposure chambers influenced response to the pesticide and how mass and survival were affected when tadpoles were exposed to an invertebrate (odonate) predator in addition to the pesticide. Mass and swim speed were measured after 4- and 12-d laboratory exposures to 1, 10, 100, and 200 ,g/L of chlorpyrifos in test chambers that either did or did not contain pond sediments. These same parameters also were examined in mesocosms dosed with 200 ,g/L of chlorpyrifos to evaluate responses under more environmentally realistic conditions. The effect of the invertebrate predators on survival and/or growth of tadpoles was evaluated in the mesocosm study and in separate laboratory experiments. In laboratory tests, no pesticide-induced mortality was observed; however, tadpole ChE activity in the two highest concentrations was significantly lowered, with a longer exposure duration further decreasing activity (maximum inhibition, 43%). Mass also was lower at higher concentrations, but this effect was not enhanced with longer duration of exposure. Reductions in ChE activity of tadpoles exposed in mesocosms were similar to those observed in laboratory experiments for the first 4 d. Tadpole swim speed and survival in the presence of a predator were not affected, with the latter largely resulting from pesticide-induced predator mortality. [source] Quantification by real-time PCR of the magnitude and duration of leucocyte-associated viraemia in horses infected with neuropathogenic vs. non-neuropathogenic strains of EHV- 1EQUINE VETERINARY JOURNAL, Issue 3 2006G. P. Allen Summary Reasons for performing study: Neurological disease in horses caused by infection with certain ,paralytic' strains of equine herpesvirus-1 (EHV-1) is a potentially devastating condition the pathogenesis of which is poorly understood. Preliminary observations in both experimentally induced and naturally occurring cases of the central nervous system disease have revealed a more robust cell-associated viraemia in horses infected with paralytic isolates of EHV-1, relative to horses infected with abortigenic isolates. To investigate further this pathogenesis - rdevant question, the present study was performed using a greater number of horses and a more precise method for quantification of EHV-1 DNA present in viraemic leucocytes. Objective: To compare the magnitude and duration of leucocyte-associated viraemia in seronegative, age-matched foals following infection with paralytic vs. abortigenic isolates of EHV-1. Methods: Peripheral blood mononuclear cells (PBMC) were collected from 20 weanling foals at 2, 4, 7, 9, 11, 14 and 21 days after intranasal inoculation with either paralytic or abortigenic isolates of EHV-1. The amount of EHV-1 DNA present in each PBMC sample was measured by real-time quantitative PCR. Results: Foals inoculated with paralytic strains of EHV-1 developed both a greater magnitude and longer duration of PBMC-associated viraemia than foals inoculated with abortigenic strains of the virus. Conclusions: Both the higher magnitude and longer duration of cell-associated viraemia contribute to the risk for development of neurological signs in horses infected with paralytic strains of EHV-1. Potential relevance: Our results provide empirically derived, scientific data that contributes to a better understanding of the pathogenetic basis for the differing abilities of paralytic and abortigenic strains of EHV-1 to cause post infection central nervous system disease in the horse. The findings identify the importance of minimising the quantitative burden of viraemic leucocytes that follows exposure to the virus, by the use of effective therapeutic antiviral drugs and efficacious prophylactic vaccines that stimulate cytotoxic immune responses against EHV-1 infected cells. [source] Treatment emergent mania responding to valproate in a Chinese female adolescent population with eating disorders: A case seriesEUROPEAN EATING DISORDERS REVIEW, Issue 6 2008Phern Chern Tor Abstract Eating disorders are commonly associated with depressive symptoms. In an adolescent and binge eating population fluoxetine is commonly used to treat co-morbid depression associated with eating disorders. In some patients this may precipitate treatment emergent mania (TEM). Risk factors in the adolescent population include being older, female, having a longer duration of illness, more previous mood episodes, a higher prevalence of subclinical hypothyroidism, early-onset anxiety and recent exposure to a mood-elevating agent. Diagnosis and management of these co-morbid conditions is challenging due to the overlapping symptomatology and the adverse effects of both conditions complicating pharmacological management. This is illustrated with three cases in a Chinese female adolescent population that experienced TEM while on fluoxetine and responded to valproate. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source] CLINICAL STUDY: Attentional bias in alcohol-dependent patients: the role of chronicity and executive functioningADDICTION BIOLOGY, Issue 2 2009Sabine Loeber ABSTRACT It has been suggested that the attention towards alcohol-related stimuli increases with the duration of drinking and alcohol dependence. The present study aimed to assess whether an attentional bias was present in detoxified alcohol-dependent patients, and if the magnitude of the attentional bias depended on the subject's drinking history and variables of executive functioning. Attentional bias was assessed in 30 alcohol-dependent patients using a visual dot-probe task with a picture presentation time of 50 ms. In addition, patients completed a variety of different cognitive tasks such as attention, continuous performance, working memory, set shifting and inhibitory control tests. Based on correlation analysis we split the patient sample on the median with regard to the duration of alcohol dependence and our results indicated a significant attentional bias towards alcohol-associated pictures in patients dependent for less than 9 years, but not in patients with a longer duration of dependence. The two patient samples differed significantly with regard to attention and working memory functioning with patients who were dependent for more than 9 years showing a greater impairment. When impairment of attention and working memory were controlled for, the group differences in attentional bias were no longer significant. Our results indicate that differences with regard to drinking-related variables as well as cognitive functioning seem to modulate attentional bias and need to be taken into account in models of drinking maintenance. [source] Bycatch in a tropical schooling , penaeid fishery and comparisons with a related, specialised trawl regimeFISHERIES MANAGEMENT & ECOLOGY, Issue 3 2009Q. DELL Abstract, The bycatch in a tropical Australian banana prawn, Penaeus merguiensis (de Man), fishery is described and contrasted with the closely related tiger prawn, Penaeus semisulcatus De Haan and Penaeus esculentus Haswell, fishery. Most of the similarity between banana prawn fishery catches was accounted for by three teleost species constituting 51.4% of the total bycatch weight. The bycatch assemblage structure of this fishery was significantly different (P < 0.05) from the adjoining tiger prawn fishery. The banana prawn fishery had a higher mean bycatch catch rate from shorter duration trawls, but lower estimated total annual bycatch (1502 t yr,1) than the longer duration trawls of the tiger prawn fishery (20 073 t yr,1). This study provides new data for quantifying bycatch and improving the accuracy of quantitative risk assessments currently being used to demonstrate sustainability of bycatch populations. The information will be incorporated into collaborative development of a long-term monitoring programme. [source] Variation in virulence among isolates of Armillaria ostoyaeFOREST PATHOLOGY, Issue 2 2002D. J. MORRISON The virulence of Armillaria ostoyae isolates from coastal (16) and interior (33) British Columbia, elsewhere in North America (eight) and Europe (six) was assessed on 2-year-old Douglas-fir seedlings in pots during a 3-year trial. Isolates from most geographical locations infected similar proportions of seedlings, had similar average damage scores and killed a similar percentage of diseased seedlings. Isolates from the coastal region had a significantly higher probability than interior isolates that a diseased seedling received a damage score > 3 on a 1,5 scale, and coastal isolates killed a higher proportion of diseased seedlings than interior isolates. The mean damage score for isolates that had been in culture for 20,25 years was about 25% lower than that for recently collected isolates. The results indicate that the higher incidence and longer duration of mortality in the southern interior of British Columbia compared to the coast can not be attributed to greater virulence of interior isolates of A. ostoyae. Variations de virulence chez des isolats de Armillaria ostoyae Des isolats de Armillaria ostoyae provenant de la côte (16 isolats) ou de l'intérieur (33) de la Colombie Britannique, ainsi que d'Amérique du Nord (8) et d'Europe (6), ont été comparés pour leur virulence sur des semis de 2 ans en pot de Pseudotsuga menziesii, suivis pendant 3 ans. Le taux d'infection, le taux moyen de dommages et la mortalitéétaient semblables avec les isolats de la plupart des origines. Sur une échelle de dommages allant de 1 à 5, la probabilité de dépasser la note 3 était significativement plus forte chez les semis infectés par les isolats de la région côtière que par ceux de l'intérieur; les isolats de la région côtière tuaient aussi plus de semis que ceux de l'intérieur. Les isolats en culture depuis 20,25 ans occasionnaient des dommages d'environ 25% inférieurs à ceux occasionnés par des isolats d'obtention récente. Les résultats montrent que la plus grande incidence et la plus grande persistance des mortalités dans le sud de la région intérieure de la Colombie Britannique, ne peuvent pas être attribuées à une plus grande virulence des isolats d' A. ostoyae de cette région. Variation der Virulenz zwischen Isolaten von Armillaria ostoyae Die Virulenz verschiedener Armillaria ostoyae -Isolate vom Küstengebiet (n=16) und dem Inneren von British Columbia (33) sowie aus anderen Gebieten Nordamerikas (8) und Europas (6) wurde an zweijährigen Douglasiensämlingen in Töpfen während drei Jahren untersucht. Die Isolate der meisten geographischen Herkünfte infizierten die Sämlinge in ähnlichem Umfang, führten zu ähnlichen durchschnittlichen Schadensklassen und töteten erkrankte Sämlinge in ähnlichem Ausmass ab. Isolate aus dem Küstengebiet hatten im Vergleich mit Isolaten aus dem Inland British Columbias aber eine signifikant höhere Wahrscheinlichkeit, dass ein erkrankter Sämling eine Schadensklasse > 3 auf einer Skala von 1,5 erreichte, und sie töteten auch mehr erkrankte Sämlinge ab. Bei Isolaten, die 20,25 Jahre in Kultur gehalten worden waren, lag das durchschnittliche Schadensausmass ca. 25% tiefer als bei Isolaten, die in letzter Zeit gesammelt worden waren. Diese Ergebnisse zeigen, dass das häufigere Auftreten und das über einen längeren Zeitraum anhaltende Absterben im südlichen Inland von British Columbia verglichen mit der Küstenregion nicht mit einer höheren Virulenz der Isolate von A. ostoyae aus diesem Gebiet erklärt werden kann. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||